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Rev. 6/09 FormST-5 SalesTaxExempt Purchaser Certificate Revenue · 2010-10-14 · Purchaser...

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Form ST-5 Sales Tax Exempt Purchaser Certificate Rev. 6/09 Massachusetts Department of Revenue State MA Part 1. Exempt taxpayer information. To be completed by exempt government or 501 (c)(3) organization. Name Smithsonian Institution - Astrophysical Observatory Address 60 Garden Street City Cambridge Exemption number 530-206-027 Zip 02138-1516 Issue date 01-04-89 Date ot expiration of certificate None Certification is hereby made that the organization named above is an exempt purchaser under Massachusetts General Laws, Chapter 64H, sections 6(d) or 6(e). All purchases of tangible personal property or services by this organization are exempt from taxation under said chapter to the extent that such property or services are used in the conduct of the business of the purchaser. Any abuse or misuse of this certificate by any tax-exempt organization or any unauthorized use of this certifi te by any individual constitutes a serious violation and will lead to revocation. Signature ~,/ Trtle Date "-J.5~"/4 Mgr, Sponsored Prgms & Procurement 10-14-2010 certificate may result in criminal tax evasion sanctions of up to one year in prison and $10,000 ($50,000 for Part 2. Agent information. To be completed by agent of exempt government or 501 (c)(3) organization. Name of agent's organization Address City Agent's name Address City State State Zip Zip I certify that in making this purchase, I am acting as an agent for the exempt organization named above (select one): o Govemment organization (local public school, city/town govemment, state agency, etc.). Attach Form ST-2, if available. If Form ST-2 is not available, enter exemption number, if known: _ o 501 (c)(3) organization (parochial school, Scout troop, etc.). Form ST-2 must be attached. Signature Trtle Date Part 3. Vendor information Vendor's name Check applicable box: [J Single purchase certificate (attach detailed receipts or complete Part 4, on reverse) o Blanket certificate This fonm is approved by the Commissioner of Revenue and may be reproduced.
Transcript

•Form ST-5

Sales Tax ExemptPurchaser Certificate

Rev. 6/09

Massachusetts

Department of

Revenue

State

MA

Part 1. Exempt taxpayer information. To be completed by exempt government or 501 (c)(3) organization.

Name

Smithsonian Institution - Astrophysical ObservatoryAddress

60 Garden StreetCity

CambridgeExemption number

530-206-027

Zip

02138-1516

Issue date

01-04-89Date ot expiration of certificate

None

Certification is hereby made that the organization named above is an exempt purchaser under Massachusetts General Laws, Chapter 64H, sections 6(d)or 6(e). All purchases of tangible personal property or services by this organization are exempt from taxation under said chapter to the extent that suchproperty or services are used in the conduct of the business of the purchaser. Any abuse or misuse of this certificate by any tax-exempt organization orany unauthorized use of this certifi te by any individual constitutes a serious violation and will lead to revocation.

Signature ~,/ Trtle Date

"-J.5~"/4 Mgr, Sponsored Prgms & Procurement 10-14-2010

certificate may result in criminal tax evasion sanctions of up to one year in prison and $10,000 ($50,000 for

Part 2. Agent information. To be completed by agent of exempt government or 501 (c)(3) organization.

Name of agent's organization

Address

City

Agent's name

Address

City

State

State

Zip

Zip

I certify that in making this purchase, I am acting as an agent for the exempt organization named above (select one):o Govemment organization (local public school, city/town govemment, state agency, etc.).

Attach Form ST-2, if available. If Form ST-2 is not available, enter exemption number, if known: _

o 501 (c)(3) organization (parochial school, Scout troop, etc.). Form ST-2 must be attached.

Signature Trtle Date

Part 3. Vendor informationVendor's name

Check applicable box:[J Single purchase certificate (attach detailed receipts or complete Part 4, on reverse)oBlanket certificate

This fonm is approved by the Commissioner of Revenue and may be reproduced.

Part 4. Description of property purchasedDate Description Quantity Cost

$

$

$

$

$

$

$

$

$

$

$

~ $

$

$

$

$

$

$

Total cost $

ST.2 MASSACHUSETTS DEPARTMENT OF REVENUE

CERTIFICATE OF EXEMPTION

Cerllficatlon is hereby made that the organization r,ereln 'lamed IS an exempt purchaser under General Laws, Chapter 64H, Sectrons 6(d)and (el. All purchases of tangible personal property by this organization are exempt from taxation under said chapter to the extent thatsuch property is used in the conduct of the business 0: the purchaser. Any abuse or misuse of this certificate by any tax.exemptorganization or any unauthorized use of this certificate by any injividual constitutes a s~"ous violation and will lead to revocation.Willful misuse of this Certificate of Exemption is subject to criminal sanctions of up to 1 year in prison and $10,000 (SSO,OOO forcorporations) In fines. (See reverse side).

SMITHSONIAN INSTITUTION1000 JEFFERSON DRIVE SOUTHWESTWASHINGTON DC 20560

NOT ASSIGNABLE OR TRANSFERABLE

EXEMPTION NUMBER E

530-206-027ISSUE DATE

01-04-89CERTIFICATE EXPIRES ON

NONE

COMMISSIONER OF REVENUE

STEPHEN W. KIDDER


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