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.
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.  
1.                        Check if this certificate is for a single purchase. Enter the related invoice/purchase order #    ___________________________.
                          A. Purchaser's name
2.

                          B. Business address                                                 City                     State            Country Zip code
                                                                                                                         
                          C. Name of seller from whom you are purchasing, leasing or renting
             Print or type
                          D. Seller’s address                                                 City                     State            Country Zip code
                                                                                                                         
3.                        Purchaser’s type of business. Check the number that best describes your business.
                          01  Accommodation and food services            08  Real estate                                 15  Professional services
                          02  Agriculture, forestry, fishing, hunting    09  Rental and leasing                          16  Education and health-care services 
                          03  Construction                               10  Retail trade                                17  Nonprofit organization
                          04  Finance and insurance                      11  Transportation and warehousing              18  Government
                          05  Information, publishing and communications 12  Utilities                                   19  Not a business
                          06  Manufacturing                              13  Wholesale trade                             20  Other (explain)
                          07  Mining                                     14  Business services

4.                        Reason for exemption. Check the letter that identifies the reason for the exemption.
                          A Federal government      (Department) *                            H  Agricultural Production *
                          B State or local government (Name) *                                I  Industrial production/manufacturing  * 
                          C Tribal government (Name) *                                        J  Direct pay permit  *  
                          D Foreign diplomat #                                                K  Direct Mail  *
                          E Charitable organization *                                         L  Other (Explain)
                          F Religious organization *                                          M Educational  Organization *
                          G Resale *
*                         see Instructions on back (page 2) 
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      ID number                                    State/Country   Reason
AR                                                                                            NV 
GA                                                                                            OH 
IA                                                                                            OK
IN                                                                                            RI
KS                                                                                            SD
KY                                                                                            TN
MI                                                                                            UT
MN                                                                                            VT
NC                                                                                            WA
ND                                                                                            WI
NE                                                                                            WV
NJ                                                                                            WY 

                          I declare that the information on this certificate is correct and complete to the best of my knowledge and belief. 
6.                        Signature of authorized purchaser                 Print name                  Title                                   Date

SSTGB Form F0003    Exemption Certificate    (Revised 12/21/2021)    

                             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 for Resale 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 (Revised 12/21/2021)