Form ST-104G
                       Sales Tax Exemption Claim 
                       Cash Purchases by Government Agencies

              Idaho Code section 63-3622O and Idaho Sales and Use Tax Administrative Rule 128
Use this form to document tax-exempt cash sales to federal government agencies, the State of Idaho or its 
agencies, departments, or political subdivisions. 

Buyer: Complete the section below and give it to the seller at the time of purchase.
Seller’s name                                           Government agency

Address                                                 Address

City                               State ZIP Code       City                        State         ZIP Code

Government purchasing agent’s name                      Government purchasing agent’s phone number

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.
Buyer’s signature                                                                                 Date

Print name                                        Title                                           Phone number

Seller: Complete the section below. Complete a separate form for each cash sale you make. This form is 
valid only if all information is complete. Keep the form with the corresponding receipt. You don’t need this 
form if the buyer provides other proof (such as a government purchase order) showing the sale is exempt.
Don’t use this form for any of the following:
•  Lodging and meals a government employee buys
•  Expenses for using a private car for which an allowance has been authorized
•  Purchases by other states, their agencies, departments, or political subdivisions
If a detailed receipt isn’t available, please list the items purchased below. Continue your list on the back of 
this form or use additional pages, if needed. 

              Items purchased                     Price        Items purchased                                Price

EFO00222     08-21-2020