Blank St 105 Indiana PDF Template
The ST-105 form, issued by the Indiana Department of Revenue, serves as a vital tool for businesses seeking sales tax exemptions in Indiana. This General Sales Tax Exemption Certificate allows Indiana-registered retail merchants and certain out-of-state businesses to make purchases without incurring sales tax, provided they meet specific criteria outlined in Indiana code. It is essential to understand that exemptions based on statutes from other states are not applicable for purchases made from Indiana vendors. The form cannot be used for purchasing utilities, vehicles, watercraft, or aircraft. To qualify for the exemption, purchasers must be registered with the Indiana Department of Revenue or possess the appropriate tax identification from their home state. Completing the form accurately is crucial; failure to provide all required information will result in the seller charging sales tax. However, if tax is mistakenly paid, purchasers can file a claim for a refund using Form GA-110L. Additionally, a valid ST-105 certificate can also exempt the purchaser from county innkeeper’s tax and local food and beverage tax. Each section of the form must be filled out completely, including identification numbers and the reason for the exemption, to ensure compliance and avoid potential penalties for misuse.
Form Sample
Form |
Indiana Department of Revenue |
(R5 / |
General Sales Tax Exemption Certificate |
State Form 49065 |
|
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, or Aircraft. 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
Section 2 Section 1 (print only)
Section 3
Section 4
Name of Purchaser:________________________________________________________________________________________
Business Address:_ _______________________ City:____________________ State:__________ 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
*See instructions on the reverse side if you do not have either number.
State ID Number:__________________________ |
State of Issue:_________________ |
Is this a □blanket purchase exemption request or a □single purchase exemption request? (check one)
Description of items to be purchased:__________________________________________________________________________
□must indicate the type of exemption being claimed for this purchase. (check one or explain)
□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 to nonprofit organizations claiming exemption pursuant to Sales Tax Information Bulletin #10. (May not be used for
□personal hotel rooms and meals.)
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.
□USDOT Number:______________________
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 - show agency name._ __________________________________________
Note: A U.S. Government agency should enter its Federal Identification Number (FID) in Section 1 in lieu of a State ID
□Number. Other - explain.________________________________________________________________________________________Purchaser
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
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.
Signature of Purchaser:______________________________________________ |
Date:_ ______________________________ |
Printed Name:_____________________________________________________ |
Title:________________________________ |
The Indiana Department of Revenue may request verification of registration in another state if you are an
Seller must keep this certificate on file to support exempt sales.
Instructions for Completing Form
All four sections of the
Section 1
A)This section requires an identification number. In most cases this number will be an Indiana Department of Revenue issued Taxpayer Identification Number (TID - see note below) used for Indiana sales and/or withholding tax reporting. If the purchaser is from another state and does not possess an Indiana TID Number, a resident state’s business license, or State issued ID Number must be provided.
B)Exceptions - For a purchaser not possessing either an Indiana TID Number or another State ID Number, the following may be used in lieu of this requirement.
Federal Government – place your FID Number in the State ID Number space. Farmer – place your SSN or FID Number in the State ID Number space.
Public transportation haulers operating under another motor carrier authority, or with a contract as a school bus operator, must indicate their SSN or FID Number in the State ID Number space.
Nonprofit Organization – must show its FID Number in the State ID Number space.
Section 2
A)Check a box to indicate if this is a single purchase or blanket exemption.
B)Describe product being purchased.
Section 3
A)Purchaser must check the reason for exemption.
B)Purchaser must be able to provide additional information if requested.
Section 4
A)Purchaser must sign and date the form.
B)Printed name and title of signer must be shown.
Note: The Indiana Taxpayer Identification Number (TID) is a ten digit number followed by a three digit LOC Number. The TID is also known as the following:
a)Registered Retail Merchant Certificate
b)Tax Exempt Identification Number
c)Sales Tax Identification Number
d)Withholding Tax Identification Number
The Registered Retail Merchant Certificate issued by the Indiana Department of Revenue shows the TID (10 digits) and the LOC (3 digits) at the top right of the certificate.
Form Specifics
| Fact Name | Details |
|---|---|
| Form Title | General Sales Tax Exemption Certificate (Form ST-105) |
| Governing Law | Indiana Code 6-2.5 (State Gross Retail Sales Tax Act) |
| Eligible Users | Indiana registered retail merchants and out-of-state businesses |
| Ineligible Purchases | Cannot be used for Utilities, Vehicles, Watercraft, or Aircraft |
| Registration Requirement | Purchasers must be registered with the Indiana Department of Revenue or their home state's taxing authority |
| Completion Requirement | All sections must be fully completed for exemption to be valid |
| Claiming Tax Refund | If unable to provide required information, tax must be paid; a claim for refund can be filed using Form GA-110L |
| Additional Exemptions | Valid for county innkeeper’s tax and local food and beverage tax |
| Identification Numbers | Purchasers must provide a TID and LOC Number or a State Tax ID Number |
| Penalties for Misuse | Misuse may lead to tax, interest, and civil or criminal penalties |
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