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It explains purchaser eligibility responsibilities, potential tax, interest, and civil or criminal penalties for ineligible claims, and limits on entity-based exemptions by seller location and state rules. The form collects purchaser and seller details, tax identifiers, business type, and exemption reason, and includes a signature and date.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/streamlined-sales-tax-agreement-certificate-of-exemption/304848/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/streamlined-sales-tax-agreement-certificate-of-exemption/304848.png","ImageObject",442,249,{"name":88,"@type":89},"Terk","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-27","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":76},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"Where should the completed exemption certificate be sent?","Question",{"text":108,"@type":109},"Send the completed form to the seller and keep a copy for your records. Do not send the form to the Streamlined Sales Tax Governing Board.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What happens if the purchaser is not eligible to claim the exemption?",{"text":113,"@type":109},"The purchaser will be held liable for any tax and interest, and possible civil and criminal penalties imposed by the member state.",{"name":115,"@type":106,"acceptedAnswer":116},"How do you identify the reason for the exemption and the purchaser’s business type?",{"text":117,"@type":109},"Circle the letter that identifies the reason for the exemption, and circle the number that best describes the purchaser’s type of business.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},304848,1790194173,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":47,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":73,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":9},1099525198933,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Streamlined Sales Tax Agreement Certificate of Exemption  \nDo not send this form to the Streamlined Sales Tax Governing Board.  \nSend the completed form to the seller and keep a copy for your records.  \nThis is a multi-state form. Not all states allow all exemptions listed on this form. Purchasers are responsible for knowing if they qualify to claim exemption from tax in the state that would otherwise be due tax on this sale. The seller may be required to provide this exemption certificate (or the data elements required on the form) to a state that would otherwise be due tax on this sale.  \nThe purchaser will be held liable for any tax and interest, and possible civil and criminal penalties imposed by the member state, if the purchaser is not eligible to claim this exemption. A seller may not accept a certificate of exemption for an entity-based exemption on a sale made at a location operated by the seller within the designated state if the state does not allow such an entity-based exemption.  \n1.  \n2.  \n3.  \n4.  \n5.  \n6.  \nCheck if you are attaching the Multistate Supplemental form.  \nIf not, enter the two-letter abbreviation for the state under whose laws you are claiming exemption.  \nCheck if this certificate is for a Single Purchase Certificate. Enter the related invoice/purchase order \\#    \nCircle type of business Print or type  \nCirc le or check reason  \nfor exemption  \nSign  \nhere  \nA. Name of purchaser  \n\n| B. Business address |  |  |  |  |  | City |  | State\u003Cbr>\u003Cbr>WV  | Zip code |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| C. Purchaser’s tax ID number |  | State of Issue\u003Cbr>WV\u003Cbr>|  |  |  | Country of Issue |  |  |  |\n| D. If no tax ID number, enter one of the following: FEIN |  |  |  |  |  |  |  |  |  |\n| E. Driver ’s License Number/State Issued ID number |  |  |  |  |  | State of Issue |  |  |  |\n| F. Foreign diplomat number |  |  |  |  |  |  |  |  |  |\n| G. Name of seller from whom you are purchasing, leasing or renting |  |  |  |  |  |  |  |  |  |\n| SUPERIOR PARTS & SERVICE LLC |  |  |  |  |  |  |  |  |  |\n| H. Seller’s address |  |  | City |  |  |  | State |  | Zip code |\n| 5100 ELK RIVER ROAD N |  |  | \u003Cbr>ELKVIEW |  |  |  | \u003Cbr>WV  |  | \u003Cbr>25071 |\n| Purchaser’s Type of business. Circle the number that best describes your business. |  |  |  |  |  |  |  |  |  |\n| 01 Accommodation and food services 02 Agriculture, forestry, fishing, hunting 03 Construction\u003Cbr>04 Finance and insurance\u003Cbr>05 Information, publishing and communications 06 Manufacturing\u003Cbr>07 Mining 08 Real estate\u003Cbr>09 Rental and leasing\u003Cbr>10 Retail trade |  |  | 11 Transportation and warehousing\u003Cbr>12 Utilities\u003Cbr>13 Wholesale trade\u003Cbr>14 Business services\u003Cbr>15 Professional services\u003Cbr>16 Education and health-care services\u003Cbr>17 Nonprofit organization\u003Cbr>18 Government\u003Cbr>19 Not a business\u003Cbr>20 Other (explain)   |  |  |  |  |  |  |\n| Reason for exemption. Circle the letter that identifies the reason for the exemption. |  |  |  |  |  |  |  |  |  |\n| A\u003Cbr>B\u003Cbr>C\u003Cbr>D\u003Cbr>E\u003Cbr>F\u003Cbr>G | \u003Cbr>Federal government (Department)   State or local government (Name)   Tribal government\u003Cbr>Foreign diplomat \\#\u003Cbr>Charitable organization \\#   Religious organization \\#   Resale \\#   |  |  | H\u003Cbr>I\u003Cbr>J\u003Cbr>K\u003Cbr>L\u003Cbr>M | Agricultural Production \\# ~~  ~~Industrial production/manufacturing \\#   Direct pay permit \\#   Direct Mail \\#   Other (Explain)   Educational Organization \\# |  |  |  |  |\n| I declare that the information on this certificate is correct and complete to the best of my knowledge and belief. |  |  |  |  |  |  |  |  |  |\n| Signature of authorized purchaser |  | Print name here | Title |  |  |  | Date |  |  |\n\nSSTGB Form F0003 Exemption Certificate (Revised 3/31/2020)  \nStreamlined Sales and Use Tax Agreement CertificateofExemption-Multi-stateSupplemental  \nName of Purchaser  \nState Reason for exemption Identification number (if required)  \nAR      \nGA      \nIA      \nIN      \nKS      \nKY  \n_____________________________ _____________","cbCairiEg3bZxmT8","https://ap.wps.com/l/cbCairiEg3bZxmT8","pdf",803599,"English","# Streamlined Sales Tax Agreement Certificate of Exemption\n## Filing and responsibility notes\n## Instructions for state and certificate type\n## Purchaser, seller, and tax information\n## Business type and reason for exemption\n## Declaration, signature, and date\n## SSUTA Multi-state Supplemental details","[{\"question\":\"Where should the completed exemption certificate be sent?\",\"answer\":\"Send the completed form to the seller and keep a copy for your records. Do not send the form to the Streamlined Sales Tax Governing Board.\"},{\"question\":\"What happens if the purchaser is not eligible to claim the exemption?\",\"answer\":\"The purchaser will be held liable for any tax and interest, and possible civil and criminal penalties imposed by the member state.\"},{\"question\":\"How do you identify the reason for the exemption and the purchaser’s business type?\",\"answer\":\"Circle the letter that identifies the reason for the exemption, and circle the number that best describes the purchaser’s type of business.\"}]","Streamlined Sales Tax Agreement Certificate of Exemption | PDF",1789818537]