Multistate_Resale_Certificate

Certificate of Exemption
Streamlined Sales Tax Agreement
How to use this form:

1) Fill out the fields in the form below.

This is a multi-state form. Not all states allow all exemptions listed on this form. Purchasers are responsible for knowing if they qualify to claim exemption from tax in the state that would otherwise be due tax on this sale. The seller may be required to provide this exemption certificate (or the data elements required on the form) to a state that would otherwise be due tax on this sale.

The purchaser will be held liable for any tax and interest, and possible civil and criminal penalties imposed by the member state, if the purchaser is not eligible to claim this exemption. A seller may not accept a certificate of exemption for 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.

2) Signing at the bottom of this document says that you have read and agreed to the above statement and the information you provided is truthful.

3) When you submit this form, it will populate the standard Streamlined Sales Tax Governing Board Tax form as a PDF.

4) After submitting, a copy of this document will be sent to the vendor and a copy kept by The Link Companies.
Any questions, please contact madisonb@thelinkcompanies.com
1.

Check if you are attaching the Multistate Supplemental form.
If not, enter the two-letter abbreviation for the state under whose laws you are claiming exemption.
2.

Check if this certificate is for a Single Purchase Certificate.
Enter the related invoice/purchase order number:
3A. Legal Company Name As Displayed on Tax Return*
Company DBA*
Submitter's Email*
example@example.com
3B. Business address*
City
State*
Zip*
3C. Purchaser’s tax ID number
State of Issue
County of Issue
3D.If no tax ID number, enter one of the following: FEIN
3E. Driver’s License Number/State Issued ID number
State of Issue
3F. Foreign Diplomat Number
3G Name of seller from whom you are purchasing.*
3H. Seller's address*
City*
ST*
Zip*
Type of business*

01 Accommodation and food services11 Transportation and warehousing02 Agriculture, forestry, fishing, hunting12 Utilities03 Construction13 Wholesale Trade04 Finance and insurance14 Business services05 Information, publishing, and communications15 Professional services06 Manufacturing16 Education and health-care services07 Mining17 Nonprofit organization08 Real estate18 Government09 Rental and leasing19 Not a business10 Retail tradeOther
Reason for exemption. Circle the letter that identifies the reason for the exemption

A. Federal GovernmentB. State or local governmentC. Tribal governmentD. Foreign diplomatE. Charitable organizationF. Religious organizationG. ResaleH. Agriculture ProductionI. Industrial product/manufacturingJ. Direct pay permitK. Direct MailL. OtherM. Education Organization
Resale Certificate Number
Description of Items Purchased*
I declare that the information on this certificate is correct and complete to the best of my knowledge and belief.
Signature of authorized purchaser*

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Name*
Title*
Date*

MonthDayYear
Date
Name of Purchaser*
State and Identification number (if required)
AK
AR
GA
IA
IN
KS
KY
MI
MN
NC
ND
NE
NJ
NV
OH
RI
OK
SD
TN
UT
VT
WA
WI
WV
WY
Reason for exemption
Resale
Date

YearMonthDay
Date
The following nonmember states will accept this certificate for exemption claims that are valid in their respective state. SSUTA Direct Mail provisions do not apply in these states.
Vendor Alt Name*
Should be Empty:

Certificate of Exemption

Streamlined Sales Tax Agreement

State and Identification number (if required)