Form ST-105, General Sales Tax Exemption Certificate Instructions
This form contains 27 fields organized into 12 sections. Below is a complete list of every field, its type, and what information is expected.
| Field Name | Type | Description |
|---|---|---|
| Business Address | ||
| Business Street Address | Text |
Enter the street address of the business.
|
| Business City | Text |
Enter the city of the business address.
|
| Business State | Text |
Enter the state of the business address.
|
| Business ZIP Code | Text |
Enter the ZIP code of the business address.
|
| Description of Items to be Purchased | ||
| Description of Items | Text |
Enter a detailed description of the items that are being purchased.
|
| Exemption Reason Checkboxes | ||
| Sales to Farmers for Agricultural Products | Radiobutton |
Check this box if the sale is to persons occupationally engaged as farmers for products used directly in the production of agricultural goods for sale.
|
| Sales to Contractor for Exempt Projects | Radiobutton |
Check this box if the sale is to a contractor for projects that are exempt, such as those for public schools, government, or nonprofits.
|
| Sales to Indiana Governmental Units | Radiobutton |
Check this box if the sale is to an Indiana governmental unit, including agencies, cities, towns, municipalities, public schools, or state universities.
|
| Indiana Registered Retail Merchant's Certificate | ||
| TID Number | Number |
Enter the 10-digit Indiana Registered Retail Merchant's Certificate TID Number as shown on your certificate.
|
| LOC Number | Text |
Enter the 3-digit Indiana Registered Retail Merchant's Certificate LOC Number as shown on your certificate.
|
| Name of Purchaser | ||
| Name of Purchaser | Text |
Please provide the full legal name of the purchaser.
|
| Other Exemption Reason | ||
| Other - explain | Radiobutton |
Check this box if your exemption reason is not listed among the other options and you need to provide a custom explanation.
|
| Other Exemption Explanation | Text |
Please provide a detailed explanation for why this exemption is being claimed under the 'Other' category. Fill only if 'Other - explain' is 'Yes'.
Depends on:
Other - explain
|
| Out-of-State Tax ID | ||
| Out-of-State Tax ID Number | Text |
Enter the tax identification number issued by another state if you are not registered with the Indiana Department of Revenue.
|
| State of Issue | Text |
Provide the name or abbreviation of the state that issued the out-of-state tax identification number. Fill only if 'Out-of-State Tax ID Number' is filled.
Depends on:
Out-of-State Tax ID Number
|
| Purchase Exemption Request Type | ||
| Blanket Purchase Exemption Request | Radiobutton |
Check this box if this is a blanket purchase exemption request.
|
| Single Purchase Exemption Request | Radiobutton |
Check this box if this is a single purchase exemption request.
|
| Purchaser Information | ||
| Signature Date | Date |
Please enter the date the purchaser signs this certificate.
|
| Printed Name | Text |
Please enter the printed name of the purchaser.
|
| Purchaser Title | Text |
Please enter the title of the purchaser within their organization.
|
| Type of Exemption Claimed | ||
| Sales for resale only | Radiobutton |
Check this box if the sale is to a retailer, wholesaler, or manufacturer for the sole purpose of resale.
|
| Sale of manufacturing machinery | Radiobutton |
Check this box if the sale involves manufacturing machinery, tools, and equipment intended for direct use in production.
|
| Sales to nonprofit organizations | Radiobutton |
Check this box if the sale is to a nonprofit organization claiming exemption under Sales Tax Information Bulletin #10, but not for personal hotel rooms or meals.
|
| Sales for public transportation | Radiobutton |
Check this box if the sale is of tangible personal property predominantly used (more than 50 percent) to provide public transportation.
|
| U.S. Federal Government Sale Details | ||
| Sales to United States Federal Government | Radiobutton |
Check this box if the sale is being made to the United States Federal Government.
|
| Federal Government Agency Name | Text |
Please provide the name of the United States Federal Government agency. Fill only if 'Sales to United States Federal Government' is 'Yes'.
Depends on:
Sales to United States Federal Government
|
| USDOT Number | ||
| USDOT Number | Number |
Please enter the USDOT (U.S. Department of Transportation) number for the business.
|