ST-105 Indiana Tax Exemption

General Sales Tax Exemption Certificate

Indiana Department of Revenue Form ST-105
Indiana registered retail merchants and businesses located outside Indiana may use this certificate. The claimed exemption must be allowed by Indiana code. Exemption statutes of other states are not valid for purchases from Indiana vendors. This exemption certificate can not be issued for the purchase of Utilities, Vehicles, Watercraft, Aircraft, or Gasoline. In addition, this exemption certificate may not be issued by a nonprofit organization. Purchaser must be registered with the Department of Revenue or the appropriate taxing authority of the purchaser’s state of residence.

Sales tax must be charged unless all information in each section is fully completed by the purchaser. Purchasers not able to provide all required information must pay the tax and may file a claim for refund (Form GA-110L) directly with the Department of Revenue. A valid certificate also serves as an exemption certificate for (1) county innkeeper’s tax and (2) local food and beverage tax.
Section 1
Name of Purchaser:*
Address:*

Business Address

Street Address Line 2

CityState

ZIP Code
Purchaser must provide minimum of one ID number below.*

Provide your Indiana Registered Retail Merchant’s Certificate TID and LOC Number as shown on your Certificate.
TID Number (10 digits):
- LOC Number (3 digits):
If not registered with the Indiana DOR, provide your State Tax ID Number from another State:
State ID Number:
State of Issue:

Section 3
Exemption Request Type:*

Blanket purchase exemption requestSingle purchase exemption request
Description of items to be purchased:*

Section 4
Purchaser must indicate the type of exemption being claimed for this purchase. (check one or explain)
Exemption Being Claimed:*

Sales to a retailer, wholesaler, or manufacturer for resale only.Sale of manufacturing machinery, tools, and equipment to be used directly in direct production.Sales of tangible personal property predominately used (greater then 50 percent) in providing public transportation provide USDOT Number. A person or corporation who is hauling under someone else’s motor carrier authority, or has a contract as a school bus operator, must provide their SSN or FID Number in lieu of a State ID Number in Section 1.Sales to persons, occupationally engaged as farmers, to be used directly in production of agricultural products for sale. Note: A farmer not possessing a State Business License Number may enter a FID Number or a SSN in lieu of a State ID Number in Section 1.Sales to a contractor for exempt projects (such as public schools, government, or nonprofits).Sales to Indiana Governmental Units (agencies, cities, towns, municipalities, public schools, and state universities).Sales to the United States Federal Government. Note: A U.S. Government agency should enter its Federal Identification Number (FID) in Section 1 in lieu of a State ID Number.Other
USDOT Number*
Agency Name:*

Section 5
I hereby certify under the penalties of perjury that the property purchased by the use of this exemption certificate is to be used for an exempt purpose pursuant to the State Gross Retail Sales Tax Act, Indiana Code 6-2.5, and the item purchased is not a utility, vehicle, watercraft, aircraft, or gasoline. I further attest that the property purchased is not being purchased by a nonprofit organization.

I confirm my understanding that misuse, (either negligent or intentional), and/or fraudulent use of this certificate may subject both me personally and/or the business entity I represent to the imposition of tax, interest, and civil and/or criminal penalties.
Printed Name:*
Title:
Signature:*

Clear
Date:*

MonthDayYear
Date
The Indiana Department of Revenue may request verification of registration in another state if you are an out-of-state purchaser.

Seller must keep this certificate on file to support exempt sales.
Should be Empty:

General Sales Tax Exemption Certificate