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Utah State Tax Commission                                                                                                            TC-160
Application for Sales Tax Exemption Number for Religious or Charitable Institutions                                                  Rev. 3/22
Name of organization

Organization’s mailing address                                    Physical address (if different from mailing address)

City                                    State ZIP Code            City                                                State ZIP Code

1.  Per administrative rule R865-19S-43, you must document your exemption status in one of the following four ways:
   a.  Attach a copy of the IRS determination letter exempting your organization from federal income tax under IRC §501(c)(3).
   b.  If your organization is claiming exemption as a subunit of a central organization, attach a copy of the central organization’s 
     religious or charitable 501(c)(3) determination letter and IRS group exemption letter naming your organization as a subunit.
   c.  If your organization is not required to have an IRS determination letter, attach documentation (copies of your Articles of 
     Incorporation, Articles of Organization, or other similar documents) showing that your organization is exempt from tax under 
     IRC(c)(3).
   d.  If your organization is a “disregarded entity” that does not have an IRS 501(c)(3) determination letter, attach the following:
     1) an affidavit or other evidence from the organization’s sole member that the organization is a “disregarded entity” within the 
     meaning of Federal Reg. §§301.7701-2 and 301.7701-3,
     2) a copy of the organization’s Articles of Organization, and
     3) a copy of the sole member’s IRS 501(c)(3) determination letter.

2. Organization’s Federal Identification Number: 
                                                  -
3.  Briefly state the specific purpose for which the organization was formed and the proposed means of obtaining funds to operate and 
   maintain the organization. Do not quote directly from the Articles of Incorporation or other submitted documents.

4.  Yes  No       Do you now or do you expect to have sales income from an unrelated trade or business as defined by the IRS?
                    Caution: Sales tax exemptions do not apply to unrelated trade or business income.
                    If “Yes,” what is the approximate yearly amount?   $________________________

Under penalties of perjury I declare that, to the best of my knowledge and belief, this application and any accompanying documents are 
true, correct and complete. I further agree to make the organization’s records available for an audit when the Tax Commission deems 
necessary to verify the proper use of the sales tax exemption account number.

Print name of officer or member                                                        Organization's telephone number      Date

Signature of officer or member                                                         Title
This form must be signed by hand after it is printed.            Print Form

Make a copy of this form for your records. Send the original to:  Religious and Charitable Section
                                                                  Utah State Tax Commission
                                                                  210 N 1950 W
                                                                  Salt Lake City, UT 84134

For more information, call the Tax Commission at 801-297-2200 or 1-800-662-4335. Our fax number is 801-297-7699.
If you need an accommodation under the Americans with Disabilities Act, email taxada@utah.gov, or call 801-297-3811 or TDD 801-297-2020. Please 
allow three working days for a response.

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