Minnesota ST3 Form Please fill out the form below and we will submit your MN ST3 form: Check if this certificate is for a single purchase and enter the related invoicePurchase Order #If you are a contractor and have a purchasing agent agreement with an exempt organization, check the box to make purchases for a spe-cific job. Enter the exempt entity name and specific project:Exempt entity nameProject descriptionEmail AddressPurchaser InformationIndividual Name *Farm Name *Phone Number *Mobile NumberBusiness Name *Type of Business *Select Business TypeAccommodation and food servicesAgricultural, forestry, fishing, huntingBusiness servicesConstructionEducationFinance and insuranceGovernmentHealthcare servicesIndividual consumerManufacturingMiningNonprofit organizationProfessional servicesReal estateRental or leaseRetailTransportation and warehousingUtilitiesWholesaleOtherBusiness Address *Apartment, suite, etcCity *State/Province *ZIP / Postal Code *Purchaser's Tax ID NumberState of IssueFEINDriver's License Number/State Issued ID Number *State of IssueType of BusinessAccommodation and food servicesAgricultural, forestry, fishing, huntingConstructionFinance and insuranceInformation, publishing and communicationsManufacturingMiningReal estateRental and leasingRetail tradeTransportation and warehousingUtilitiesWholesale tradeBusiness servicesProfessional servicesEducation and health-care servicesNonprofit organizationGovernmentNot a business (explain)Other (explain)Reason for ExemptionView InstructionsFederal government (department)Specific government exemptionTribal government (name)Foreign Diplomat #Charitable organization #Educational organization #Religious organization #ResaleQualifying capital equipment (see instructions when equipment claimed is part of a construction project)Agricultural productionIndustrial production/manufacturingDirect pay authorizationMultiple points of use (services, digital goods, or computer software delivered electronically)Direct mailOther (enter number from instructions)If percentage is checked - specify amount belowPercentage exemptionAdvertisingUtilitiesElectricityI declare that the information on this certificate is correct and complete to the best of my knowledge and belief. (PENALTY: If you try to evade paying sales tax by using an exemption certificate for items or services that will be used for purposes other than those being claimed, you may be fined $100 under Minnesota law for each transaction for which the certificate is used.)Printed name *Title *Date *Submit Signature Clear
