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Form 21919 Application for Sales Tax Exemption Certificate

north dakota exemption-cert.pdf

Form Instructions

INSTRUCTIONS: NORTH DAKOTA APPLICATION FOR SALES TAX EXEMPTION CERTIFICATE (Form 21919)

North Dakota government units on the state, local or federal level, as well as hospitals, schools and various administrators of medical care qualify for a sales tax exemption. This is applied for by filing a form 21919 with the state tax commissioner. This document can be obtained from the website of the North Dakota government.

North Dakota Application For Sales Tax Exemption Certificate 21919 Step 1: The first section of the form requires your organization's name, its Federal Employer Identification Number, and its phone number.

North Dakota Application For Sales Tax Exemption Certificate 21919 Step 2: The second section requires the complete street address of your organization.

North Dakota Application For Sales Tax Exemption Certificate 21919 Step 3: If your mailing address is different, list it in the next section.

North Dakota Application For Sales Tax Exemption Certificate 21919 Step 4: The next section requires you to indicate with a check mark your type of organization. The first line lists federal government, state, county or township, city, and Native American tribal governments.

North Dakota Application For Sales Tax Exemption Certificate 21919 Step 5: The next line lists public or private schools, colleges and universities, as well as voluntary health associations.

North Dakota Application For Sales Tax Exemption Certificate 21919 Step 6: For all organizations below listed, you must enter your North Dakota Department of Health license number. The next line should be checked by intermediate care facilities.

North Dakota Application For Sales Tax Exemption Certificate 21919 Step 7: The next line should be checked by assisted living facilities.

North Dakota Application For Sales Tax Exemption Certificate 21919 Step 8: The next line should be checked by basic care facilities.

North Dakota Application For Sales Tax Exemption Certificate 21919 Step 9: The next line should be checked by emergency medical services providers.

North Dakota Application For Sales Tax Exemption Certificate 21919 Step 10: The next line should be checked by hospitals.

North Dakota Application For Sales Tax Exemption Certificate 21919 Step 11: The final line should be checked by skilled nursing facilities.

North Dakota Application For Sales Tax Exemption Certificate 21919 Step 12: Write an explanation of your organization's primary function. Indicate with a check mark if your organization has a sales and use tax permit or if it conducts any retail sales. Sign and date the form.

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