Signed _______________________________________________ Signed _______________________________________________
Title __________________________ Date __________________ Title __________________________ Date __________________
MAIL ORIGINAL APPLICATION TO THE TAXPAYER SERVICE CENTER
LISTED ON PAGE TWO THAT SERVES THE COUNTY IN WHICH YOU ARE LOCATED.
REVENUE DEPARTMENT USE ONLY
Examiner’s Remarks ____________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
Examiner _____________________________________ Date ___________________
Supervisor’s Recommendation ___________________________________________________________________________________
_______________________________________________________________________________________________________________
Supervisor _____________________________________ Date ___________________
An Alabama Sales Tax Certificate of Exemption shall be used by persons, firms, or corporations coming under the provi-
sions of the Alabama Sales Tax Act who are not required to have a Sales Tax License
.
PLEASE COMPLETE EACH LINE APPLICABLE TO YOUR BUSINESS. A SALES TAX CERTIFICATE OF EXEMP-
TION WILL NOT BE ISSUED UNTIL THIS APPLICATION IS PROPERLYCOMPLETED.
1. Federal Employer Identification Number (FEIN) _______________________ 2. Business Telephone (______)_____________
3. ___________________________________________________________________________________________________________
NAME OF PERSON(S), FIRM, CORPORATION, ASSOCIATION, CO-PARTNERSHIP MAKING APPLICATION.
__________________________________________________________________ 4. Contact Person _________________________________
GIVE TRADE NAME
5. Mailing address of home office________________________________________________________________________________
P. O. BOX OR STREET NO. OR R.F.D.
___________________________________________________________________________________________________________
CITY COUNTY STATE ZIP CODE
6. Number of businesses in Alabama __________ Location __________________________________________________________
CITY STREET AND NO. OF HWY. COUNTY
Location must be exact street number or, if on highway or rural route, give details of location. If more than one location,
please attach schedule._______________________________________________________________________________________
7. Would you like to receive a courtesy email notification to renew your certificate?
6
No
6
Yes
If Yes, enter email address ___________________________________________________________________________________
8. Kind and Class of Business ___________________________________________________________________________________
(NON-PROFIT, WHOLESALER, MANUFACTURER, ETC.)
9. Type Product Manufactured and/or sold _______________________________________________________________________
10. REASON EXEMPTION CLAIMED___________________________________________________________________________
11. Form of ownership:
6
Individual
6
Partnership
6
Corporation
6
Multi member LLC
6
Single member LLC
If applicant is a corporation, a copy of the certified certificate of incorporation, amended certificate of incorporation,
certificate of authority, or articles of incorporation should be attached. If the applicant is a limited liability company or a
limited liability partnership, a copy of the certified articles of organization should be attached.
12. Ownership information (please attach):
Corporations – give name, title, home address, and Social Security Number of each officer.
Partnerships – give name, home address, Social Security Number or FEIN of each partner, and valid Alabama driver’s
license or other acceptable citizenship documentation.
Sole Proprietorships – give name, home address, Social Security Number of owner, and valid Alabama driver’s license or
other acceptable citizenship documentation.
LLC – give name, home address, and Social Security Number or FEIN of each member. (Valid Alabama driver’s license
or other acceptable citizenship documentation is required for single member LLCs.)
LLP – give name, home address, and Social Security Number or FEIN of each partner.
ALABAMA DEPARTMENT OF REVENUE
SALES AND USE TAX DIVISION
Application for Sales Tax Certificate of Exemption
ST: EX-A1
5/20
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