Tax Exemption Request Form

This form should be completed and submitted by individuals or organizations applying for exemption from specific taxes or government-imposed fees. Please ensure all required fields are filled and provide supporting documentation when necessary.

Applicant Information

Full Name: {fullName}

Organization Name (if applicable): {organizationName}

Tax Identification Number: {taxIdNumber}

Address: {address}

Phone Number: {phoneNumber}

Email: {email}

Exemption Details

Type of Tax/Fee for Which Exemption is Requested: {taxType}

Reason for Exemption:

{exemptionReason}

Attached Supporting Documents

{#supportingDocuments}

• {documentDescription}

{/supportingDocuments}

Applicable Period

Requested Start Date: {startDate}

Requested End Date: {endDate}

Declaration

I, {fullName}, declare that the information provided in this application is true and complete to the best of my knowledge. I understand that any misrepresentation may disqualify me from receiving a tax exemption.

Date of Application: {applicationDate}

Signature: _______________________________

{#authorizedRepresentative}

Authorized Representative (If applicable)

Name: {repName}

Position: {repPosition}

Contact Number: {repContact}

Email: {repEmail}

{/authorizedRepresentative}

Office Use Only

Received By: {receivedBy}

Date of Receipt: {dateOfReceipt}

Application Reference Number: {applicationRef}

Review Notes

{#reviewNotes}

• {note}

{/reviewNotes}

Decision: {decision}

Approved By: {approvedBy} on {approvalDate}