City of Gustavus
PO Box 1
Gustavus, Alaska 99826
Phone: (907) 697-2451
APPLICATION FOR SALES TAX EXEMPTION CERTIFICATE
Fee $10.00
I, _____________________________________________________________, _________________________
Name Title
Representing ________________________________________________________________, a nonprofit
Organization Name
organization whose mailing address is ___________________________________________________
Mailing Address
___________________________________________________
City, State, Zip
hereby apply for a Sales Tax Exemption Certificate under Section 4.15.040 of the City of
Gustavus Sales Tax Ordinance. I certify the attached evidence of our Internal Revenue Service
classification of 501 (c)(3) or 501(c) (4) is in good standing.
My organization _____DOES _______DOES NOT maintain a physical presence in the City of
Gustavus.
I am aware that all nonprofit organizations that maintain a physical presence with the City of
Gustavus must register with the City Treasurer, or the official administering this ordinance
and report their sales.
I am aware this certificate exempts the organization’s purchases and those sales that are not
subject to federal income tax.
____________________________________________________________________ ___________________
Signature Date
Applications MUST be accompanied by the following required attachments:
1. A copy of the letter from the Internal Revenue Service announcing your classification
status as a 501 (c) (3) or a 501 (c) (4), and
2. Payment of the $10.00 application fee, and
3. A completed City of Gustavus Business Registration Form – This requirement only
applies to nonprofit organizations that maintain a physical presence with the City of Gustavus
that have not previously registered with the City Clerk or the official administering this
ordinance.
Applications received without the required documents or payment will not be processed.
FOR OFFICE USE ONLY
Certificate Number _________________ Date _______________________________
Fee Paid$___________________ Cash_________ Check # _____________
__________________________________________
City Treasurer, Gustavus
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signature
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