Form ST-110
                      Petition for Sales Tax Records Reduction 
                      By a Retail Food Store
Business name                                                                 Idaho seller’s permit number

Address

City                                                               State      Zip Code

As a retail food store primarily engaged in the business of selling food for home preparation, I request relief 
from the responsibility of keeping detailed invoices for untaxed sales. I’m making this petition according to 
Idaho Code section 63-3624(d).

If the Tax Commission grants this petition, I agree to maintain the required substitute form of documentation 
(Form ST-111).

The nature of my retail food store is:

       Grocery store                             Meat or fish market

       Fruit and vegetable market                Dairy products store

       Candy, nut, or confectionery store        Other food store
                                                                                      (Specify)
       Retail bakery

By signing this form, I certify that the statements I made on this form are true and correct. I know that 
submitting false information can result in criminal and civil penalties.
Authorized signature                                                          Date

Title                                                                         Phone number

                      Mail to: Idaho State Tax Commission, PO Box 36, Boise  ID  83722-0410
                      Call the Tax Commission at (208) 334-7660 in the Boise area or toll free at 
                              (800) 972-7660, if you need help with this form.

                                                 For State Use Only
       We’ve approved your request for records reduction, effective

       We denied your request for records reduction. We’ve enclosed the reasons for the denial and 
       information about your right to appeal.

Idaho State Tax Commission, authorized signature Title                            Date

EFO00106    06-15-2020