Fillable LODGING SALES TAX EXEMPTION (Idaho State University)

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LODGING SALES TAX EXEMPTION (Idaho State University)

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I am an employee of a(n):
U.S. Government Agency
Name of Agency:
Qualifying Type of Card: Purchase Card Fleet Card Travel Card
Credit Card Number:
• Purchase cards will be either VISA (beginning with 4486, 4614, or 4716) or MasterCard (beginning with 5565 or 5568).
• Fleet cards will be either Voyager (beginning with 8699) or MasterCard (beginning with 5565 or 5568).
• Travel cards will be either VISA (beginning with 4486 or 4614) or MasterCard (beginning with 5565 or 5568). Travel cards with the sixth digit
of 6, 7, 8, 9, or 0 are billed directly to the government agency and qualify for exemption.
• Charges to travel cards with the sixth digit of 1, 2, 3, or 4 are billed directly to the employee, do not qualify for the tax exemption, and are
subject to tax.
Idaho State Government Agency
(StateschoolsareincludedasnonprotschoolsunderOtherQualiedOrganizations.)
Name of Agency:
Credit Card Number:
• Qualifying cards are Visa issued by Bank of America. They include the name of the agency and usually the name of a state employee. The
cardisspecicallymarked"TaxExempt."OthercardssuchasDinersClub,whichincludethestateagencyandanemployeename,are
billed directly to the employee and do not qualify for exemption.
Idaho Local Government Agency or Other Qualied Organization*
*(Seethebackofthisformforqualiedorganizations.)
 NameofAgencyorQualiedOrganization:
Type of Card:
Credit Card Number:
ST-104-HM
EFO00164
11-02-12
Idaho State Tax Commission
SALES TAX EXEMPTION ON LODGING ACCOMMODATIONS
ClaimedbyEmployeesUsingAQualifyingCreditCardPayment
Hotel/Motel/Campground Name (Seller) Guest (Name) Driver'slicensenumber
Address Address
City State Zip Code City State Zip Code
I certify that all statements I have made on this form are true and correct to the best of my knowledge. I understand that falsication of this certicate for the purpose of
evading payment of tax is a misdemeanor. Other penalties may also apply.
Signature of Guest Work Address Date Work Phone Number
• This form may be reproduced. • This form is valid only if all information is complete. • The seller must keep this form.
This exemption does not apply if you pay charges from your own personal funds or from
expense reimbursements. To qualify, the credit card company must directly bill your
employer.
MasterCard Visa AmericanExpress
Diner'sClub Other
(Name of Card)
Denitions for Idaho Form ST-104-HM
Sales Tax Exemption on Lodging Accommodations
Exempt Entities. Rooms or campground spaces
furnished to government entities, educational
institutions, or hospitals are exempt from the taxes if the
charge is billed directly to—and paid directly by—the
government entity, educational institution, or hospital.
“Billed directly to” means a contractual agreement
between the facility operator and an exempt entity
where the charge for the room or campground space
is directed to, and is the responsibility of, the exempt
entity. “Billed directly to” also includes credit card
charges billed to an account opened by an exempt
entity.
QUALIFIED ORGANIZATIONS
American Indian Tribes - Tribal entity only, sales made
to tribal members off the reservation do not qualify.
American Red Cross
Amtrak
Blind Services Foundation, Inc.
Centers for Independent Living
-Onlynonresidential
centers run by disabled persons that provide
independent living programs to people with various
disabilities qualify.
Emergency Medical Service Agencies
Forest Protective Association
Idaho Foodbank Warehouse, Inc.
Nonprot Canal Companies
Nonprot Hospitals
Nonprot Schools-Onlynonprotcolleges,
universities, and primary, charter, and secondary
schools qualify. Schools primarily teaching
subjects like business, dancing, dramatics, music,
cosmetology, writing, and gymnastics do not qualify.
Auxiliaryorganizations,suchasparent-teacher
associations and alumni groups, do not qualify.
Senior Citizen Centers
State/Federal Credit Unions
Volunteer Fire Departments
“Paid directly by” means a payment by an exempt
entity to the facility operator. It does not include a
payment by an exempt entity to an employee or agent
for reimbursement of expenses incurred during business
travel. However, “paid directly by” does include
paymentsmadebyanexemptentitytoanancial
institution for credit card charges made on a charge
account in the name of the exempt entity with a credit
card issued to the entity itself and not to any individual
or employee.
Credit cards issued to employees of government
agenciesareNOTconsideredtobebilleddirectlyto,
and paid directly by, the government entity when the
employee is responsible for paying the credit card
company.
Qualied Health Organizations -Onlythesequalify:
American Cancer Society
AmericanDiabetesAssociation
American Heart Association
Arthritis Foundation
The Arc, Inc.
Children'sHomeSocietyofIdaho
EasterSeals
Idaho Community Action Agency
FamilyServicesAllianceofSEIdaho
Idaho Cystic Fibrosis Foundation
IdahoDiabetesYouthPrograms
IdahoEpilepsyLeague
IdahoLungAssociation
Idaho Primary Care Association and
its Community Health Centers
IdahoRonaldMcDonaldHouse
IdahoWomen'sandChildren'sAlliance
MarchofDimes
Mental Health Association
MuscularDystrophyFoundation
National Multiple Sclerosis Society
Rocky Mountain Kidney Association
SpecialOlympicsIdaho
UnitedCerebralPalsy
Government -OnlythefederalgovernmentandIdaho
State, county, or city government qualify. Sales to other
states and their political subdivisions are taxable.
EFO00164
11-02-12
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LODGING SALES TAX EXEMPTION (Idaho State University)

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Completed 24 July 2020

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