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                                                                                                                        Wisconsin Department of Revenue
Application for Wisconsin Sales and Use Tax                                                                                                         PO Box 8902
Certificate of Exempt Status (CES)                                                                                            Madison WI 53708-8902

This form is for certain nonprofit organizations, federal and Wisconsin governmental units, and federally recognized American Indian 
tribes or bands in this state. See reverse side for instructions. 
   Name of Organization

    Business Address (number and street)

    City                                                         State  Zip Code                                      County

    Mailing Address (if different from above)               City                                         State        Zip Code

    Name of Contact Person                                              Email Address

    Phone Number                                                        Organization’s Website, if any
  (      )        –

  Type of Organization (check one): 
    a.  Religious       b. Educational        c. Scientific      d.  Charitable        e. Youth             f.  Prevention of cruelty to children or animals
    g.  501(c)(2) as described in under sec. 77.54(9a)(fc), Wis. Stats. h. Cemetery company or corporation under sec. 77.54(9a)(i), Wis. Stats.
    i   United States governmental unit       j.  Any federally recognized American Indian tribe or band in this state
    k.  Wisconsin governmental unit  (check the box that best describes your Wisconsin governmental unit):
            State of Wisconsin or any agency thereof
            Wisconsin county, city, village, or town.
            Wisconsin public schools, school districts, universities, and technical college districts.
            County-city hospital established under sec. 66.0927, Wis. Stats., and local cultural arts district under subch V of ch. 229, Wis. Stats.
            Sewerage commission organized under sec. 281.43(4), Wis. Stats., metropolitan sewerage district organized under secs. 200.01 to 200.15 or 
           200.21 to 200.65, Wis. Stats., or joint local water authority under sec. 66.0823, Wis. Stats.
            Local exposition district, under subch II of ch. 229, or any other unit of government in Wisconsin or any agency or instrumentality of one or more
           units of government in this state.
           University of Wisconsin Hospitals and Clinics Authority, the Wisconsin Aerospace Authority, the Wisconsin Economic Development Corporation, or 
           the Fox River Navigational System Authority.
 
    L.  Other (describe)

  If you checked box a, b, c, d, e, f, or L above, does your organization meet the requirements of sec. 501(c)(3) of the IRC?     Yes               No
  If yes, attach the organization’s Internal Revenue Service (IRS) determination letter. See instructions.

  Do you make or intend to make any sales of property or services which are subject to the Wisconsin sales or use tax?  ....      Yes               No
  If yes, your organization may need to apply for a seller’s permit. See instructions. 
  Note: United States governmental units are not required to obtain a seller’s permit.

  Do you hold a Wisconsin seller’s permit for sales and use tax purposes?       Yes  Permit #         456 –                                         No

  Federal Employer Identification Number             –

I declare under penalties of law that I have examined this information and to the best of my knowledge and belief, it is true, correct, and complete.
  Signature                                                 Title                                                             Date

  Print Name                                                                                                   Phone Number
                                                                                                                      ( )        –
S-103 (R. 02-21) 

                                      PURPOSE OF THIS FORM

Purchases by certain nonprofit organizations, governmental units, and tribes described below are exempt from Wisconsin 
sales or use tax. The department issues Certificate of Exempt Status (CES) numbers to help retailers identify organizations 
that qualify for this exemption. The following organizations may apply for a CES number by completing this application.

 1.  Nonprofit organizations with a 501(c)(3) determination letter from the IRS and churches and religious organizations 
    that meet the requirements of section 501(c)(3) of the Internal Revenue Code (IRC).

 2.  Federal and Wisconsin governmental units. Governmental units of other countries and states will not be issued a CES.

 3.  Federally recognized American Indian tribes or bands in this state.

 4.  Other organizations described in sec. 77.54(9a), Wis. Stats.

                                             INSTRUCTIONS

 1. Nonprofit Organizations:  Check the box that best describes your organization. Include a copy of the organization’s 
    501(c)(3) determination letter from the IRS. Churches and religious organizations that meet the requirements of section 
    501(c)(3) of the IRC are not required to provide a determination letter.

 2. Governmental Units:  A CES number will be issued to the government unit level holding the Federal Employer 
    Identification Number (FEIN) for the unit. In lieu of providing suppliers a CES number, a federal or Wisconsin gov-
    ernmental unit may provide a Wisconsin sales and use tax exemption certificate (Form S-211) or a purchase order 
    identifying the governmental unit as the purchaser.

 3. Tribes:  A CES number will be issued to the federally recognized American Indian tribe or band in Wisconsin.

 4. Other  Organizations:   Provide  documentation  or  information  showing  the  organization  is  the  type  described  in 
    sec. 77.54(9a), Wis. Stats.

 5. Seller’s Permit:  A nonprofit organization or Wisconsin governmental unit is required to charge Wisconsin sales tax 
    on retail sales of tangible personal property or taxable services, unless the sales qualify as exempt occasional sales 
    or are otherwise exempt. For more information, see Fact Sheet 2106,     Occasional Sales Exemption for Nonprofit 
    Organizations.

 6.  Send completed application to the Wisconsin Department of Revenue.

Questions:  Phone:      (608) 266-2776
                 Fax:   (608) 327-0232
                 Email: DORRegistration@wisconsin.gov
                 Website:  www.revenue.wi.gov

                                      Applicable Laws and Rules
 This document provides statements or interpretations of the following laws and regulations in effect as of February 24, 2021:  
 Section 77.54(9a), Wis. Stats., and secs. Tax 11.05, 11.14, 11.17, 11.19, 11.48, 11.68, 11.87, and 11.92, Wis. Adm. Code.

S-103 (R. 02-21)