I declare that the information on this certificate is correct and complete to the best of my knowledge and belief.
Signature of authorized purchaser
Print name
Title
Date
Print or type
Purchaser’s type of business. Check the number that best describes your business.
01 Accommodation and food services
02 Agriculture, forestry, fishing, hunting
03 Construction
04 Finance and insurance
05 Information, publishing and communications
06 Manufacturing
07 Mining
15 Professional services
16 Education and health-care services
17 Nonprofit organization
18 Government
19 Not a business
20 Other (explain)
B. Business address City State Country Zip code
C. Name of seller from whom you are purchasing, leasing or renting
D. Seller’s address Zip code
Reason for exemption. Check the letter that identifies the reason for the exemption.
A Federal government (
Department) *
B State or local government (Name) *
C
T
ribal government
(Name) *
D
Foreign diplomat #
E
Charit
able organization
*
F Religious organization *
3.
4.
City State Country
H
Agricultural Production *
I
Industrial production/manufacturing
*
J
Direct pay permit *
K
Direct Mail *
L
Other (Explain
)
M Educational Organization *
SSTGB Form F0003 Exemption Certificate (Revised 12/21/2021)
Streamlined Sales Tax Certificate of Exemption
Do not send this form to the Streamlined Sales Tax Governing Board.
Send the completed form to the seller and keep a copy for your records.
08 Real estate
09 Rental and leasing
10 Retail trade
11 Transportation and warehousing
12 Utilities
13 Wholesale trade
14 Business services
This is a multi-state form for use in the states listed. Not all states allow all exemptions listed on this form. The purchaser is responsible for
ensuring it is eligible for the exemption in the state it is claiming the tax exemption from. Check with the state for exemption information
and requirements. The purchaser is liable for any tax and interest, and possible civil and criminal penalties imposed by the state, if the
purchaser is not eligible to claim this exemption.
*
G Resale *
see Instructions on back (page 2)
AR
GA
IA
IN
KS
KY
MI
MN
NC
ND
NE
NJ
6.
NV
OH
OK
RI
SD
TN
UT
VT
WA
WI
WV
WY
ID number State/Country Reason
___________________________.
2.
1. Check if this certificate is for a single purchase. Enter the related invoice/purchase order #
A. Purchaser's name
5. Identification (ID) number: Enter the ID number as required in the instructions for each state in which you are claiming an
exemption. If claiming multiple exemption reasons, enter the letters identifying each reason as listed in Section 4 for each state.
ID number State/Country Reason
StreamlinedSalesandUseTaxExemptionCertificateInstructions
Sections1‐6arerequiredinformation.Asignatureisnotrequiredifinelectronicform.
Section1:Checktheboxforasinglepurchaseandentertheinvoicenumber.Iftheboxisnotchecked,thiscertificateisconsidereda
blanketcertificateandremainseffectiveuntilcancelledbythepurchaserifpurchasesarenomorethan12monthsapart,unlessa
longerperiodisallowedbyastate.
Section2:Enterthepurchaser’sandseller’sname,streetaddress,city,state,countryandzipcode.
Section3TypeofBusiness:Checkthenumberthatbestdescribesthepurchaser’sbusinessororganization.Ifnoneofthecategories
apply,check20andprovideabriefdescription.
Section4ReasonforExemption:Checktheletterthatidentifiesthereasonfortheexemption.Iftheexemptionyouareclaimingisnot
listed,check“LOther”andprovideaclearandconciseexplanationoftheexemptionclaimed.Notallstatesallowallexemptionslisted
onthisform.Thepurchasermustcheckwiththatstateforexemptioninformationandrequirements.
Section5IdentificationIDNumber:
Purchaser'sInstructions:
EntertheIDnumberasrequiredintheinstructionsbelowforeachstateinwhichyouareclaiminganexemption.Identifythestateorif
aforeignID,thecountrytheIDnumberisfrom.Ifmultipleexemptionreasonsarebeingclaimedenterthelettersidentifyingthe
reasonsforexemptionaslistedinSection4foreachstate.
IDNumbersforExemptionsotherthanresale:Youareresponsibleforensuringthatyouareeligiblefortheexemptioninthestateyou
areclaimingthetaxexemption.ProvidetheIDnumbertoclaimexemptionfromsalestaxthatisrequiredbythetaxingstate.Checkwith
thatstatetodetermineyourexemptionrequirementsandstatus.
Foreigndiplomatsandconsularpersonnelmustentertheirindividualtaxidentificationnumbershownontheirsalestaxexemptioncard
issuedbytheUnitedStatesDepartmentofState'sOfficeofForeignMissions.
IDNumbersforResalePurchases(IncludingDropShipments):Ifyouareclaimingapurchaseisnotsubjecttotaxbecauseitisforresale
(ExemptionReasonG.)andyouare:
1. Requiredtoberegisteredinthestateyouareclaimingthetaxexemption:ProvideyoursalestaxIDnumberissuedbythatstate.If
claimingexemptioninOHandregistrationisnotrequiredinthestate,enteranytaxIDnumberissuedbyOH.Ifclaimingexemption
inMIandregistrationisnotrequiredinthestate,enter“NotRequired”.
2. Notregisteredinthestateyouareclaimingthetaxexemption:ProvideyoursalestaxIDnumberissuedbyanystate.
3. Notrequiredtoregisterforsalestaxandyoudonothaveasalestaxidentificationnumberfromanystate:Enter
‐YourFEIN.
‐IfyoudonothaveaFEIN,enteradifferentstate‐issuedbusinessIDnumber.
‐Ifyoudonothaveanystate‐issuedbusinessIDnumberorFEIN,enteryourstatedriver'slicensenumber.
4. AforeignpurchaserandyoudonothaveanIDnumberdescribedin1,2or3:ThefollowingstateswillacceptthetaxIDnumber
(e.g.,VATnumber)issuedbyyourcountry:AR,IN,KS, KY,ND, NJ,OK,RI,SD,TN,UT,WA,WY.AllotherstatesrequireanID
numberas listed in1,2or3.
IfyoudonothaveanyoftheIDnumberslistedin1thru4:YouarenotrequiredtolistanIDnumberforthefollowingstates:NE,OH,
SD,WI.Enter"NotRequired"andthereasonforexemptionforthatstate.AllotherstatesrequireanIDnumber.
Seller’sInstructions
Thesellerisnotrequiredtoverifythepurchaser’sIDnumberordeterminethepurchaser'sregistrationrequirements.(GArequires
thesellerverifythepurchaser’sIDnumber.)Thesellerisrequiredtomaintainproperrecordsofexempttransactionsandprovidethose
recordstothestatewhenrequestedintheforminwhichitismaintained.Thesecertificatesmaybeprovidedinpaperorelectronic
format.
Thesellerisnotliableforanytax,interest,orpenaltyifthepurchaserimproperlyclaimsanexemptionorprovidesincorrectinformation
onthecertificate,providedallthefollowingconditionsaremet:
1. Thefullycompletedexemptioncertificateisprovidedtotheselleratthetimeofsaleorwithin90dayssubsequenttothedateofsale;
2. Thesellerdidnotfraudulentlyfailtocollectthetaxdue;and
3. Thesellerdidnotsolicitcustomerstounlawfullyclaimanexemption.
Note:Asellermaynotacceptacertificateofexemptionforanentity‐basedexemptiononasalemadeatalocationoperatedbythe
sellerwithinthedesignatedstateifthestatedoesnotallowsuchanentity‐basedexemption.
DropShipperInstructions:ThedropshippermayacceptanIDnumbertoclaimtheresaleexemptionasprovidedaboveinthe
Purchaser’sInstructions.TheIDnumbermayincludeanIDnumberissuedbyanotherstate.ThismayresultinthesameIDnumber
beingusedformultiplestatestoclaimtheresaleexemption(e.g.,aretailerormarketplacesellermayonlyberequiredtoregisterfor
salestaxinonestate).
SSTGBFormF0003ExemptionCertificatePage2(Revised12/21/2021)