Resource Database List/Custom Data Pull Request
The fee for this service is $100 for non-profits and $200 for for-profit businesses. Tax Exemption ID Number required
Need by Date (please allow 3 business days):
-
Month
-
Day
Year
Date
Name of Requestor:
First Name
Last Name
Business/Organization Name:
Mailing Address of Business/Organization:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you South Dakota sales tax exempt?
Please Select
Yes
No
South Dakota Sales Tax Exempt ID #:
Phone Number:
-
Area Code
Phone Number
E-mail:
example@example.com
Fields of Data Needed that you are requesting - please check all that apply:
Program name
Mailing address
Main phone number
Main E-mail
Name of Senior Administrator (CEO, President)
E-mail of Senior Administrator
Type of resource - please check all that apply:
Non-profit
Profit
Government
Community groups
Sports
Religious
Civic/service
Hobbies
Hotlines
Professional organizations
Schools
Support Groups
Please specify counties you'd like info pulled from:
Purpose for which data will be used:
Other information needed - not included on this form:
Submit
Should be Empty: