tax exempt form .pdf
PDF 309 KB Posted
- Attached to
- M4 Carbine Rifles FY 26 FCC Terre Haute
- Solicitation number
- 15B41826Q00000025
About this file
Summary of Form ST-105: Indiana General Sales Tax Exemption Certificate
This is an Indiana Department of Revenue form used by registered retail merchants and businesses located outside Indiana to claim sales tax exemption on purchases from Indiana vendors. The form is specifically completed by the Federal Correctional Complex - Terre Haute, located at 4700 Bureau Road South, Terre Haute, Indiana 47802. The purchaser has provided Indiana Registered Retail Merchant's Certificate ID 35.2850280 (LOC 001) and State Tax ID 015007010, indicating a blanket purchase exemption request.
The exemption is claimed under the category of "Sales to the United States Federal Government," with the purchasing agency identified as the Department of Justice (DOJ) - Federal Bureau of Prisons. The certificate certifies under penalty of perjury that property purchased is for exempt use pursuant to the State Gross Retail Sales Tax Act, Indiana Code 6-2.5, and that items are not utilities, vehicles, watercraft, or aircraft. The form requires the purchaser's signature and confirms that misuse or fraudulent use of the certificate subjects both the individual and business entity to imposition of tax, interest, and civil or criminal penalties. The seller must retain this certificate on file to support exempt sales.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Questions and Answers for vendors RFQ15B41826Q0000025.docx | DOCX document | |
| Federal Excise Tax Exempt.png | PNG image | |
| Questions and Answers for vendors RFQ15B41826Q0000025.docx | DOCX document | |
| Updated combined synopsis solicitation (2).docx | DOCX document | |
| Amendment to RFQ15B41826Q0000025.docx | DOCX document | |
| Updated 15B41826Q00000025 (2).pdf | ||
| 15B41826Q00000025.pdf |
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Text version
FormST-105 51111 Pamt 49116.S R-¥ I-OS lndiaaa De.putmeat of Revenue General Sales 1u Ezemptloa CertUlcab!
lndiua rqi,lcted RClil mcrc:hanll IDcl bmi1111111e1 located OUllide Iadi111.t may me Ibis eortificarc. The claimed mm, :itiOII must be allowed by Indiana code. em:s.,iicm llltalCS m Olbcr 11ate1 � DOt valid tea- pwt:baa from lndilm wmdon. 11dl aemptlaa cer1il lmll cm not be .__ far lbe pardllle r/. llfMIII, lMlda, Bf& p .. or &iml& .Pardwer mmt be nptc:red wxh the Department of ftiM:lwe er the appropriare llXing llldlodlydlbe �•• 11a1c mmideDcc.
Sales tu - be dmrpd ... 1111 illlmalllJlm ID e.cll .cica -- campleted bJ tile pan:ul& Pun:bu= I DDt able to provide all required infllnlaioD IIIUll J11SJ diem ad may file a cllim for refund (Fem GA-11<1..) directly with the Dcpctmcnt of Revcz uc.
Name m Pmt:lius Federal Correctional Complex • Terre Haute
Buuess Addrm 4700 Bureau Road South City Terre Haute State�- z.ip _4_78_0_2 __ _
Purcllllcr must provide minimum of ODe ID number below.•
Provide your Indiana �glsund Rmil Merchant'• Ccnmcate '11D ud LOC Number u lhown m your Catificate... ........... -•• -....... -·-----------m» (10 dips) If llOt � with die lndlua DOR. provide your Sim Tu m Number from U1D1bcr- S111e . ..:. ...... --···-.. ··-'"---·-· .. --.. -.... _., ... ____ 0_150_07_0_1_0 __ _ -S-Dllllractical aa 1be l'ff1lnl! lide If 10II do not ban �namber. Sim IDf
LOOI ( 3 diJjll)
�oflaae
I b Ibis a 1ZJ blanket pan:buc �OD request or a � smile purch.ue exemption .requeat? (check one)
Dclcripdom ditcmstobcplll"Cbued. _____________________________ _
Pllrcbaser lIIUll indicue lhe type d c:xcmplioa being claimed for !his purcbu:. (dleck ODC or explam)
C Selel to a retailer, wbolmalcr, or numafacturer far fflllle only.
C Sale of IJIIIIUfllCIUrin& machiua,, toola, ud equipment to be 1181111 directly in dir=ct production.
C Sales to JIOIIJll"llllt orpnlzatlom cJa1minc exempli011 pursuant to Salcl Tu lnfo.rmalion BvJletln #10.
(May 110t be um! far pcrslJllll lioE:l nxm11 and meals.)
CJ Sm of lallgiblc pmonal pnipcny predaminatcly Ull!d (grcaier then SO percent) in providing pablk: tnmpa 1ation - provide USDOTI.
A pcn0ll or carpoimiol1 who is hlulins UDdar someone cl1e'1 motQr carder authority, or has a con� as a ICh DOI b111 operator, mu5t pcovidc lbc:ir SSI or PID# in lieu of a Sia� IDt In Sectioa #I. USDOff ______ _
C Siles to pcnam, occupationally mJapd a, farmers, to be u,od dim:tl)' in prodaction of qricnltun1 product! for la1c.
- . Note: A fllnncr not poueuinJ ,.State BUlineu Uca:nd may enter a P!DI or a SSf in lieu of a State.ID# ins, 1Cti011 fl.
CJ Sm ID I tDDtnldDr for exmnpt projects (such. public IChook, government, or nonprofits).
C Sale5 ro lndiaDII Go,e11m1mtal llnill (agencies, cities. rowns, municipalilic&, public sclloob., md state univei- 1itic&).
IZI Sales 10 die United Slates Federal Gcmnameat • show apcy name. DOJ • Federal Bureau of Prison _s _______ _ Note: A U.S. Gcm:nlment -,ency lhoald enter ill Pllderal ldeDtificati011 Nmnbe:r (FID#) iii Section tl ill lieu or a Sbm: ID#.
I brftby cer1lfy undec die penalties ol petjary that the property purchased by lbc we at: lhis e1.empti011 cemficm is iD be used for an acmpt pirpose pun11111110 die Slale 0nm Rerail Siles Tu Ac:t, bldialll Code 6-2..5, and the nem purclw;ai is not a unlity, v :bic:k. watercraft, or ain:nll
I caafinn my Ulldr:ntlndiq that milue, (either nqUlffll or UIUlllioM{), ml/or fnutdul,:nt II.le ol dlil ccttific:atc m ry subjllc:C both me pcnonally IDd/ar the busiDcu entity f l'llpRIICllt 10 die impositi011 of IIX, inla'elt, and civil md/ry crin:mw penalties.
Spture of Purchasc:r _____________________ _ O.te --------
Prinllld Name _________________________ _ Title _______ _ 'The Indiana Depatanenl o( Revcuuc: may n:qucst vcrific:llion of regisnticm in anod!er stare if you an: an oul• ::>f-stnte purchaset.
Seller mast mp lml c:cttificate OD me ID support uempt ales.
35-2850280
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