Streamlined Sales and Use Tax Agreement – New Jersey                                                              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. Not all states allow all exemptions listed on this form. Purchasers are responsible for knowing if they qualify to claim exemption 
from tax in the state that would otherwise be due tax on this sale. The seller may be required to provide this exemption certificate (or the data elements 
required on the form) to a state that would otherwise be due tax on this sale.
The purchaser will be held liable for any tax and interest, and possibly civil and criminal penalties imposed by the member state, if the purchaser is not 
eligible to claim this exemption. 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.
1.   Check if you are attaching the Multi-State Supplemental form.
      If not, enter the two-letter postal abbreviation for the state under whose laws you are claiming exemption.
2.   Check if this certificate is for a single purchase and enter the related invoice/purchase order # 
3.  Print or Type
    Name of purchaser

    Business address                                                   City                                         State                  ZIP Code

    Purchaser’s tax ID number                                          State of Issuance                            Country of Issuance

                              FEIN                    Driver’s License Number/State Issued ID Number                      Foreign diplomat number
    If no tax ID, enter one                                          
    of the following:
                                                 State of Issuance:           Number:
    Name of seller from whom you are purchasing, leasing, or renting

    Seller’s address                                                   City                                         State                  ZIP Code

4. Purchaser’s Type of business.Check the box for the number that describes your business.
     01 Accommodation and food services                                        11 Transportation and warehousing
     02 Agricultural, forestry, fishing, hunting                               12 Utilities
     03 Construction                                                           13 Wholesale trade
     04 Finance and Insurance                                                  14 Business services
     05 Information, publishing, and communications                            15 Professional services
     06 Manufacturing                                                          16 Education and health-care services
     07 Mining                                                                 17 Nonprofit organization
     08 Real Estate                                                            18 Government
     09 Rental and leasing                                                     19 Not a business
     10 Retail trade                                                           20 Other (explain) 
5.  Reason for exemption. Check the box for the letter that identifies the reason for 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 # 
6.  Sign here.
I declare that the information on this certificate is correct and complete to the best of my knowledge and belief.
Signed authorized purchaser                      Print name here                                       Title                           Date

Streamlined Sales and Use Tax Agreement                         Certificate of Exemption – Multi-State Supplemental
Name of Purchaser
State                     Reason for Exemption                                 Identification Number (if required)
AR                                                             
GA                                                              
IA                                                             
IN                                                             
KS                                                             
KY                                                             
MI                                                             
MN                                                             
NC                                                             
ND                                                             
NE                                                             
NJ                                                             
NV                                                             
OH                                                             
OK                                                             
RI                                                             
SD                                                             
TN*                                                            
UT                                                             
VT                                                             
WA                                                             
WI                                                             
WV                                                             
WY                                                             

*SSUTA Direct Mail provisions are not in effect for Tennessee.

The following nonmember states will accept this certificate for exemption claims that are valid in their respective state. SSUTA Direct Mail provisions do 
not apply in these states.

XX                                                             
XX                                                             
XX                                                             
XX                                                             
XX                                                             
XX                                                             
XX                                                             
XX                                                             
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XX                                                             

                         Streamlined Sales and Use Tax Agreement – New Jersey
                                      Certificate of Exemption Instructions

Use this form to claim exemption from sales tax on purchases of otherwise taxable items. The purchaser must complete 
all fields on the exemption certificate and provide the fully completed certificate to the seller in order to claim exemption.

Warning to purchaser: You are responsible for ensuring that you are eligible for the exemption you are claiming. You will 
be held liable for any tax and interest, and possibly penalties imposed by the member state due the tax on your purchase, 
if the purchase is not legally exempt.

Purchaser instructions for completing the exemption certificate

1. Some purchasers may wish to complete a single certificate for multiple states where they conduct business and reg-
   ularly make exempt purchases from the same seller. If you do, check the box on the front of the SSUTA Certificate of 
   Exemption to indicate that you are attaching the Multi-State Supplemental form.

  Caution: Certificates completed with a multi-state supplement may include nonmember states of the SST Governing 
   Board, provided those states have agreed to accept the SSUTA Certificate of Exemption. Both sellers and purchasers 
   must be aware that these additional nonmember states may not have adopted the SSUTA provisions for Direct Mail. 
   Additionally, completion of this certificate in its entirety may not fully relieve the seller from liability unless nonmember 
   states’ requirements have been met.

  If you are not attaching the Multi-State Supplemental form, enter the two-letter postal abbreviation for the state under 
   whose laws you are claiming exemption. For example, if you are claiming an exemption from sales or use tax imposed 
   by the state of Minnesota, enter “MN” in the boxes provided. If you are claiming exemption for more than one member 
   state, complete the SSUTA Certificate of Exemption: Multi-State Supplemental form.

2. Single purchase exemption certificate: Check this box if this exemption certificate is being used for a single pur-
   chase. Include the invoice or purchase order number for the transaction.

  If this box is not checked, this certificate will be treated as a blanket certificate. A blanket certificate continues in force 
   so long as the purchaser is making recurring purchases (at least one purchase within a period of 12 consecutive 
   months) or until otherwise cancelled by the purchaser.

3. Purchaser information: Complete the purchaser and seller information section, as requested. An identification num-
   ber for you or your business must be included. Include your state tax identification number and identify the state and/or 
   country that issued the number to you. If you do not have a state tax identification number, enter the federal employer 
   identification number (FEIN) issued to your business, or if no FEIN is required, enter your personal driver’s license 
   number and the state in which it is issued. Foreign diplomats and consular personnel must enter the individual tax 
   identification number shown on the sales tax exemption card issued to you by the United States Department of State’s 
   Office of Foreign Missions.

   Identification numbers for resale purchases: If you are claiming that a purchase is not subject to tax because it is for 
   resale (exemption reason G) and you are:
   • Required to be registered in New Jersey – Provide your New Jersey Sales Tax identification number.
   • Not registered in New Jersey – Provide your sales tax identification number issued by any state.
   • Not required to register for sales tax and you do not have a sales tax identification number from any state: 
     — If you have an FEIN; enter your FEIN 
     — If you do not have an FEIN, enter a different state-issued business identification number.
   • A foreign purchaser and you do not have an identification number described in 1, 2, or 3 – Enter the tax identification 
     number (e.g., VAT number) issued by your country.

   Multi-state purchasers: The purchaser should enter its headquarters address as its business address.

4. Type of business: Check the box for the number that best describes your business or organization. If none of the cate-
   gories apply, check the box for 20 and provide a brief description.

5. Reason for exemption: Check the box for the exemption that applies to you and your business and enter the addition-
   al information requested for that exemption. If the member state that is due tax on your purchase does not require the 
   additional information requested for the exemption reason code checked, enter “NA” for not applicable on the appropri-

  ate line. New Jersey law does not allow for the exemptions referenced in C, E, F, and M. Therefore, those exemptions 
  have been stricken. In addition, B only applies to purchases made by New Jersey State or New Jersey local govern-
  ments for purchases less than $150.

  Exemptions not listed: The New Jersey Division of Taxation issues preprinted exemption forms directly to taxpayers 
  that qualify for exemption under UEZ (the Urban Enterprise Zone program), BRRAG (Business Retention and Reloca-
  tion Assistance Grant program), or are qualified exempt organizations. Your UZ-4, UZ-5-SB, ST-4 (BRRAG), or ST-5 
  must be supplied to claim exemption on these grounds.

  If some other exemption that is not listed applies, circle “L Other” and enter an explanation. The explanation for “L Oth-
  er” must include a clear and concise explanation of the reason for the exemption claimed. Some more common exemp-
  tions that may be listed as explanation could be: wrapping materials, research and development, commercial truck, etc. 

  Multi-state purchasers: Attach the SSUTA Certificate of Exemption – Multi-State Supplemental form and indicate the 
  applicable reason for exemption and identification number (if required) for each of the additional states in which the pur-
  chaser wishes to claim exemption from tax.

  Caution: The exemptions listed are general exemptions most commonly allowed by member states. Howev-
  er, each state’s laws governing exemptions are different. New Jersey law provides for several exemptions that 
  are not specifically named on this form. For general information on the taxability of common goods and services, 
  and the applicability of the sales tax exemptions allowed under New Jersey law, see the Division’s website at: 
  nj.gov/treasury/taxation/businesses/salestax/index.shtml  .

Seller: You are required to maintain proper records of exempt transactions and provide those records to member states 
of the SST Governing Board, Inc., when requested. These certificates may be provided in paper or electronic format. If 
a paper exemption certificate is not forwarded by the purchaser, but instead the data elements required on the form are 
otherwise captured by the seller, the seller must maintain such data and make it available to member states in the form in 
which it is maintained by the seller.

You are not required to verify the purchaser’s identification number or determine the purchaser’s registration require-
ments.

You are relieved of the responsibility for collecting and remitting sales tax on the sale or sales for which the purchaser 
provided you with this exemption certificate, even if it is ultimately determined that the purchaser improperly claimed an 
exemption, provided all of the following conditions are met:

1. All fields on the exemption certificate are completed by the purchaser or the required information is captured and main-
  tained. (The reason code ID # in Section 5 is not required for the exemption certificate to be fully completed);

2. The fully completed exemption certificate (or the required information) is provided to you at the time of sale or as other-
  wise provided by Section 317 of the SSUTA;

3. If the purchaser is claiming an entity-based exemption (i.e., an exemption based on who the purchaser is) the state that 
  would otherwise be due the tax on the sale allows the specific entity-based exemption claimed by the purchaser if the 
  purchase was made at a sale location operated by the seller within that state;

4. You do not fraudulently fail to collect the tax due; or

5. You do not solicit customers to unlawfully claim an exemption.