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--- | --- | --- | --- |\n|  |  |  |  |  |  |\n| ITEM PURCHASED FOR EXCLUSIVE USE OF THE UNITED STATES GOVERNMENT (Describe)   |  |  |  | QUANTITY   | UNIT PRICE($)   |\n|  |  |  |  |  |  |\n| VENDOR FROM WHICH PURCHASED   |  |  | A tax exemption form  \u003Cbr>has not previously  \u003Cbr>been issued and the  \u003Cbr>described item(s)has  \u003Cbr>(have)been delivered  \u003Cbr>and invoiced  \u003Cbr>pursuant to:   | AMOUNT OF TAX EXCLUDED($)   |  |\n| NAME   |  |  |  | STATE   |  |\n|  |  |  |  | LOCAL   |  |\n| ADDRESS (Number,Street,City,State,and ZIP Code)   |  |  |  | FOR ADMINISTRATIVE OFFICE   |  |\n|  |  |  | PURCHASE OR  \u003Cbr>CONTRACT NUMBER   | DESIGNATED OFFICE SYMBOL NUMBER   |  |\n|  |  |  |  |  |  |\n|  |  |  | DATES   | VOUCHER NUMBER   |  |\n|  |  |  |  | DATE:   |  |\n\nThe information on this form is true and correct to the best of my knowledge and belief.  \n\n| PURCHASER'S SIGNATURE   | DATE:   |\n| --- | --- |\n\n# PURCHASER'S OFFICE TITLE\n\nPURCHASER'S ADDRESS  \nDATE:  \nSIGNATURE OF VENDOR'S REPRESENTATIVE  \nTITLE OF VENDOR'S REPRESENTATIVE  \n# INSTRUCTIONS\n\n1.This form will be used to establish the Government's exemption or immunity from State or Local taxes whenever no other evidence is available.  \n2.This form shall NOT be used for:  \n(a)Purchase of quarters or subsistence made by employees in travel status.  \n(b)Expenses incident to use of a privately owned motor vehicle for which a mileage allowance has been authorized,or  \n(c)Merchandise purchased which is subject only to Federal Tax.  \n3.If the spaces provided on the face of this form are inadequate,attach a separate statement containing the required information.  \n4.If both State and Local taxes are involved,use aseparate form for each tax.The form will be provided to the vendor when the prices exclude State orLocal tax.  \n5.The serial number of each form prepared will be shown on the payment voucher.  \nTHE FRADULENT USE OF THIS FORM FOR THE PURPOSE OF OBTAININGEXCEPTION FROM OR ADJUSTMENT OF TAXES IS PROHIBITED.","cbCaicW3xhLYbyRk","https://ap.wps.com/l/cbCaicW3xhLYbyRk","pdf",1342335,"English","# Instructions\n## Allowed use\n## Prohibited use\n## Additional statement and separate forms","[{\"question\":\"What is the purpose of this tax exemption form?\",\"answer\":\"It is used to establish the Government's exemption or immunity from state or local taxes when no other evidence is available.\"},{\"question\":\"When must the form not be used?\",\"answer\":\"Do not use it for employee travel quarters or subsistence, for expenses related to privately owned motor vehicle mileage allowances, or for merchandise subject only to Federal tax.\"},{\"question\":\"What should be done if the form fields are insufficient?\",\"answer\":\"Attach a separate statement containing the required information.\"}]","SF1094-15c - United States Tax Exemption Form | PDF",1789783615]