Home Depot
BestBuy
Preapproved:
Walmart
Five Below
Nirchis
Wegmans
Michaels
Clear Form
Submit
New York State Department of Taxation and Finance
New York State and Local Sales and Use Tax
Exempt Organization
Exempt Purchase Certificate
ST-119.1
(10/11)
Select single purchase for almost all purchases, except organizations like 9800
Single purchase certificate
Select single purchase for almost all purchases, except organizations like 9800
Blanket certificate
Your exempt organization number (6-digit number issued
by the New York State Tax Department)
is not your
federal employer identification number.
Will be autopopulated on submission
Exempt Organization Number
Name of the seller is typically the vendor
Name of seller
Street address
City
State
Zip
Will be autopopulated on submission
Name of purchaser
Street address
City
State
Zip
Select Your Organization
0001 SEE BELOW
1000 SA Operating Account
1001 SA Payroll
1002 OCCT Payroll Account
4000 Black Dance Repertoire
4010 Student Psychological Association
4020 Animation Club
4025 Association for Applied Sciences - AABS
4030 Binghamton Crosbys
4035 Binghamton Skate club
4040 Black Student Union
4050 Mock Trial Association
4055 MODA X
4060 American Society of Mechanical Engineering
4065 Binghamton Aiding Hearts
4080 Binghamton Art Club
4085 Bing Assoc for Transfer Students
4100 Harpur Harpeggios
4160 Harpur's Ferry Student Volunteer Ambulance
4160S Harpur's Ferry Scholarship Account
4160ST Harpur's Ferry State Grant
4160V Harpur's Ferry Vehicle
4170 SEEK (High Hopes Crisis Intervention)
4200 Circle K
4210 ESCAPE Bus Company
4215 Consult Your Community
4220 Latin American Student Union
4245 Lebanese Student Association
4250 Ballroom Dance Association
4255 Bangali Student Association
4260 Explorchestra
4265 Thai Student Organization
4270 Pipe Dream
4285 Pre-Occupational & Physical Therapy Assoc (POPTA)
4290 Pre-Medical Association
4300 Hillel-Jewish Student Union
4320 Candid Photography Club
4325 REACH
4330 Fashion Industry Club
4335 Fashion Runway
4340 Rhythm Method
4360 Hindu Student Council
4370 Harpur Jazz Project
4390 National Association of Black Accountants
4395 Best Buddies
4430 Rotaract
4440 Piano Society
4450 Equality Project (The)
4470 Harpur Radio Workshop (WHRW)
4490 Feminist Collective
4505 Garden Club
4530 College In The Woods Council
4540 Hinman College Council
4550 Newing College Council
4560 Off Campus College Community (OC3)
4570 New York Public Interest Research Group
4575 One World
4590 Dickinson Town Council
4605 Undivided: Multicultural R&B Group
4610 Rainbow Pride Union
4615 Rena Magazine
4620 Hellenic Cultural Society
4630 Bing Real Estate
4640 Psi Chi, National Honor Society
4645 Quiz Bowl
4650 Art Co-op
4660 African Student Organization
4665 College Diabetes Network
4675 Alzheimer's Foundation of America On Campus
4680 Pre-Optometry Association
4700 Caribbean Student Association
4705 Colorstack
4710 Cosplay Club
4715 Helping Chintsa
4718 Data Science and Analytics
4720 Pakistani Students Association
4725 The Pappy Parker Players
4730 OCC Transport
4740 Partners in Health
4750 Nursing Students Association
4755 Minecraft
4760 Student Volunteer Center
4765 History Club
4770 Campus Survival Games
4780 Hong Kong Exchange Square
4787 Association for Women in Mathematics
4790 Powerful United Ladies Striving to Elevate
4800 Muslim Student Association
4805 National Alliance on Mental Illness
4810 Film and Production Society
4820 SUNY Kids
4830 Pre-Physician Assistant Society
4840 Accounting Association
4870 Women Empowered Support, Protect, Educate, Advocate and Know
4875 Happy Medium
4910 SHINE
4920 Students of Urban Planning
4925 Candela: Latin Dance Club
4930 Binghamton Transfer Student Association
4970 Binghamton e-NABLE
4975 BridgeUSA
5010 German Club
5015 Get Reel Fishing Club
5020 Human Development Association
5025
5028 Olami JHealth
5030 Teachers in Math
5032 EndAlz
5034 Matryoshka Club
5035 Semper Fi Society
5040 Binghamton Upcycle
5050 Society for Human Resource Management
5060 Bhangra
5065 Billiards Club
5066 Planned Parenthood Generation Binghamton
5070 Aviation Student Association
5075 Audubon Society Club (Bird Club)
5085 Binghamton Bicycle Co-op
5088 Binghamton Automotive Enthusiasts Club
5090 Undergraduate Chemical Society
5100 Korean Undergraduate Student Association
5125 Korean Int'l Student Assoc
5130 Medical Research Interest Club
5140 MASTI
5160 Sikh and Punjabi Student Association
5185 oSTEM
5190 Blacks, Latinos, Asians, & Caucasians Keeping Unity
5200 Free Press
5210 Diverse Cultural Excellence
5225 Gift of Life
5235 Girl Gains at BU
5240 Evolution Dance Company
5250 Tap That
5260 Biochemistry Club
5265 Citizens' Climate Lobby
5270 SUNY VINES
5275 NAACP - Natl Assoc for the Advancement of Colored People
5277 Black TranscenDance Majornoir
5280 Board Game Group
5290 Circus Arts Association
5310 Korean American Baptist Student Organization
5320 Korean American Christian Fellowship
5325 Bing Swifties
5330 Sikh Association
5335 Albanian Student Association
5370 Scrabble Club
5380 Taste Buds
5390 SnoCats Ski & Snowboard Club
5410 College Republicans
5420 Interdisciplinary Research Club
5440 Mountainview College Council
5445 Muggles
5470 Imagination Craft Works
5480 Binghamton Prospect Magazine
5500 Givology
5510 Sigma Alpha Lambda
5515 Binghamton Buddies
5525 BU Breakers
5550 Casino in the Woods Committee
5560 Note to Self
5610 Irish Student Union
5615 Queer Leadership Advancement
5618 One Health Medical Assoc
5620 Poker Club
5625 BEAM
5650 Chabad
5670 Intervarsity Christian Fellow
5690 Student Design Agency
5720 Turkish Culture Association
5740 Association of Latino Professionals in Finance and Accountin
5745 Astronomy Club
5775 Mafia Club
5779 APICS - Association for Operations Mgmt
5780 International Entertainment Club
5790 Sul Poong
5810 Model United Nations Team
5820 Pep Band
5830 Enactus
5850 Engineers Without Borders
5854 Henna Club
5940 Treblemakers
5950 Meor
5955 Microbiology Club
5970 American Cancer Society On Campus
6070 Intramural Sports
6080 Russian Student Union
6110 Habitat For Humanity
6115 Charity Water at Binghamton University
6118 Moot Court Club
6120 Students for Justice in Palestine
6140 Binghamton Vibrations
6145 Change of Tone
6150 Asian Student Union
6155 Binghamton University Bees
6160 Business Fashion Society
6162 Binghamton University Bouncers
6165 Binghamton Army ROTC Club
6170 Chinese Christian Fellowship
6180 Cheese Club
6185 Bake Back America at Binghamton
6190 Charles Drew Minority Pre-Health Society
6220 Susquehanna Community Council
6225 Green Wolverine
6230 No Strings Attached
6235 Kpop
6240 Environmental CHANGE
6250 Indian InternationaI Student Union
6260 Math Club
6290 Convocations
6310 Informations Systems Club
6335 Binghamton Bowling
6340 Diversity, Inclusion, and Belonging Club (DIB)
6360 American Red Cross Club
6370 Disabled Student Union
6390 Collectible Card Game Association
6400 Senior Class Council
6410 Junior Class Council
6420 Sophmore Class Council
6430 Freshman Class Council
6435 Sound of Binghamton
6440 Finance Society
6510 Mary E. Mahoney Nursing Support Group
6520 Pre-Pharmacy Association
6530 Chess Club
6550 Hilarity for Charity
6560 Product Mgmt Dev Program
6570 Pre-Genetic Counseling Club
6575 Pre-Law Education Organization
6580 Pre-Veterinary Society
6590 College Democrats
6610 Institute of Electrical and Electronics Engineers
6660 Ellipsis Literary Magazine
6670 Italian Club
6690 Student Environmental Action Coalition
6710 Stand Up
6720 International Flag Dancers
6730 Big Brothers Big Sisters
6800 Amnesty International
6840 Haitian Student Association
6850 Friendly Lunch
6855 Friends of MSF at Binghamton University
6860 Binghamton Review
6880 Guitar Club
6910 Speech and Debate
6920 Student United Way of Binghamton
6990 Actuarial Association
7025 Tech Collective
7040 Personal Finance Association
7050 National Society of Black Engineers
7070 Society of Asian Scientists and Engineers
7080 TEDx Binghamton University
7085 Young Democratic Socialist of America at Binghamton University
7090 Chinascope
7100 Binghamton Law Quarterly
7105 Binghamton Fujianese Union
7123 Neurodiversity Club
7125 Plant Based Bing
7130 Binghamtonics
7140 Economics Club
7160 Food Co-Op
7170 International Connection
7175 Ice-Skating Club
7200 College Progressives
7220 Society of Hispanic Professional Engineers
7225 NYS Mentoring Club
7240 Student's For Sunrise
7270 KnitWits
7280 Origami Club
7283 Dominican Student Association
7290 X-Fact'r Step Team
7300 Spanish Club
7310 Uncommon Grounds
7315 S.E.L.F.
7325 Ukrainian Cultural Assoc (UCA)
7330 Uyai Nnua
7350 March of Dimes
7360 Pre Dental Association
7370 Poverty Awareness Coalition
7380 Hillside Village Council
7400 Binghamton Sound Stage & Lighting
7420 Thurgood Marshall Pre-Law Soc.
7425 TOPSoccer
7450 Society of Automotive Engineers
7480 Juvenile Urban Multiculture Program
7520 Society of Women Engineers
7530 Neuroscience Club
7535 Paws and Effect
7540 Newman Association
7570 Club Sports
7590 Late Night Binghamton
7610 BU Association of Mixed Students (BAMS)
7620 BU Zoo (The)
7660 Global Education Investment
7665 Global Medical Missions Alliance
7810 Democracy Matters
7840 Campus Climate Challenge
7850 College Libertarians
7880 Zionist Organization
7885 Zero Hour Binghamton
7920 Pokemon Fan Club
7930 Boys and Girls Club Mentors
7960 Microfinance Connection
7970 Dickinson Community Players
8020 Water for Life
8080 Voices Against Violence
8090 Women in Business
8100 SHADES
8105 Binghamton Poetry Club
8115 Pre-SOMA
8120 Arabic Association
8122 Pretty Girls Sweat
8125 Foundations
8128 Binghamton Scientista
8130 Interfaith Council
8135 Marketing Association
8140 Men of Color Scholastic Society
8142 Swipe Out Hunger at BU
8145 Biological Science Club
8148 Students for Rare Diseases
8150 Education Club
8155 Comic Club
8160 Sports Debate
8165 Sports Management Group
8170 Glee Club
8175 Meditation Club
8185 Thai Cultural Awareness
8190 Video Game Association
8195 Students for Sensible Drug Policy
8200 Wishmakers on Campus
8202 Medical Roots Project
8212 She's the First
8215 Speech and Language Association
8220 Car Club
8225 Production & Mixing
8235 American Medical Women's Association
8245 Management Consulting Group
8250 Spirit in the Box
8255 Quimbamba
8260 L.O.C.K.S.
8265 Rocket Club
8270 Hula Hooping Club
8275 Kurdish Student Union fka American Kurdish Council
8280 Operation Smile
8281 Binghamton Policy Project
8285 Veterans Student Organization
8300 China Care Club
8310 Film Salon
8315 Hinman Production Company
8320 Universities Allied for Essential Medicines
8330 Fine Arts Society
8335 Evolutionary Studies Student Organization
8345 Active Minds
8350 Student Alliance for Local Living Economies
8352 Financial Literacy for the Youth
8355 American Sign Language Club
8360 Pediatric Cancer Awareness
8370 Binghamton Bookworms
8375 BU Science
8380 Polish Student Association
8390 Scholars for Soldiers
8393 Binghamton Investment Association
8395 Undergraduate Art History Association
8400 State of Mind
8405 Angels of the Amazon
8406 The Binghamton Performing Arts
8408 Storytelling Workshop Club
8415 The Binghamton University Times Tribune (The BUTT)
8420 Corazoncitos
8425 Students for Educational Reform
8430 Binghamton Students for Autism Acceptance
8435 MEDLIFE
8440 Page Turners
8445 Fellowship of Christion Athletes
8450 Harpur Vocal Jazz
8455 American Parliamentary Debate Association
8460 Advertising Group
8465 J Street U
8470 Dorm Room Diplomacy
8472 DOVE
8475 Paranormal Association
8480 Deeds for Diabetes
8485 KONECT
8490 Mechanical Contractors Association of America
8495 Chanbara
8500 SA INK
9100 Business Replacement
9110 Capital Replacement
9120 Discretionary Fund
9125 Community Discretionary Fund
9130 Fundraising Supplement
9199 FinCo Allocations (Capital/Business Replacment)
9200 Student Congress
9202 President Office
9300 Student Association Program Bd
9400 Semi Formal
9410 EVP Office
9500 VPSS Office
9502 VPSS - Support
9503 VPSS - Grants
9510 Academic Readership Program
9600 VPMA Office
9602 VPMA – Grants
9700 Marketing and Publications (MAP) Department
9800 Student Association
9810 E-Board Programming
9850 Deficit Coverage
9860 Advertising Subsidy
9870 Rollover Adj
9880 Relay for Life Event Fund (CAC)
9890 SA Gives
9895 SA Charity
Certified Treasurer Email
The exempt organization
must be the direct purchaser and payer of record.
You may
not
use this form
to purchase motor fuel or diesel motor fuel exempt from tax.
Representatives of governmental agencies or diplomatic missions
may
not
use this form.
Carefully read
the instructions and other information on the back of this document.
______________________________________________________________________________
I certify that the organization named above holds a valid Form ST-119,
Exempt Organization Certificate,
and is exempt from New York State and local sales and use taxes on its purchases.
Certification:
I certify that the above statements are true, complete, and correct, and that no material information has been omitted. I make these statements and issue this exemption certificate with the knowledge that this document provides evidence that state and local sales or use taxes do not apply to a transaction or transactions for which I tendered this document and that willfully issuing this document with the intent to evade any such tax may constitute a felony or other crime under New York State Law, punishable by a substantial fine and a possible jail sentence. I understand that this document is required to be filled with, and delivered to the vendor as agent for the Tax Department for purposes of section 1838 of the Tax Law and is deemed a document required to be filed with the Tax Department for the purpose of prosecution of offenses. I also understand that the Tax Department is authorized to investigate the validity of tax exclusions or exemptions claimed and the accuracy of the information entered on this document.
Will be autopopulated on submission
Officer name:
Title:
Signature:
Date:
Please check for a confirmation email to print your form (
check your spam folder!
).