C-6205-ST             STATE OF NEW JERSEY-DIVISION OF TAXATION-REVENUE PROCESSING CENTER       PO Box 252
 11-99, R-7           REQUEST TO BE PLACED ON A NON-REPORTING BASIS                            Trenton, NJ  08646-0252

I hereby request to be relieved of the obligation to file New Jersey Sales and Use Tax Returns (ST-50/51).  This business makes no sales of goods or services
subject to sales tax, does not lease any goods subject to use tax, and has not had use tax liability averaging over $2,000 during the past three years.
(Note:  Businesses whose annual use tax liability exceeded $2,000 for the three previous years must be on a reporting basis for Sales and Use Tax Returns.
Businesses with no taxable sales or leases, who did not have use tax liability exceeding that threshold, may report their use tax liability on an annual ST-18B.)
I understand that if I engage in any activity that requires the collection of Sales and Use Tax, I must notify the Division of Taxation immediately. I also certify
that I have read the reverse side of this card and I am aware that if any statement on this request is fraudulent, I may be subject to fine or imprisonment or both.

 • REGISTRATION NUMBER ______________________________________
 • ______________________________________________________________ • ______________________________________________________
 Taxpayer’s Name                                                  Type of Business
 • ______________________________________________________________ • ______________________________________________________
 Trade Name                                                       Principal Product/Service
 • ______________________________________________________________ • ______________________________________________________
 Street Address       City  State Zip                             Business Telephone Number
 ___________________________________________________________________________________________________________________________
 Authorized Signature                                             Title                        Date
                                  PLEASE READ REVERSE SIDE

                                  (Reverse)

                                  NOTICE

            The falsification of any statement on this request, the failure to file required returns, and the failure to remit taxes
     due, with the intent to defraud the State or avoid payment of tax, are third-degree crimes, in violation of N.J.S.A. 54:52-
     10, 54:52-8, or 54:52-9, respectively, and are subject to punishment pursuant to the provisions of Title 2C of the New
     Jersey statutes.

                            FOR OFFICIAL USE ONLY
                                                                           …      APPROVED
                                                                           …      DENIED
                                                                           …      FURTHER INQUIRY REQUIRED

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                      Agent                                       Location                 Date