DEPARTMENT OF TREASURY BUREAU OF ALCOHOL, TOBACCO AND FIREARMS EXEMPTION CERTIFICATE (For use by States and local governments (section 4221(a)(4) of the Internal Revenue Code)-2026

1. Click ‘Get Form’ to open it in the editor.
2. Enter the date at the top of the form. Ensure you format it correctly as 'Month, Day, Year'.
3. In the section labeled 'I hereby certify that I am', input your title and the name of your state or local government.
4. Select the applicable type of certificate by checking either 'The article or articles specified in the accompanying order' or 'All orders placed by the purchaser for the period'.
5. Fill in the period for which this exemption applies, ensuring it does not exceed 12 calendar quarters.
6. Provide the name of the manufacturer from whom purchases will be made and specify that these are for exclusive use by your governmental unit.
7. Sign and date at the bottom of the form, then enter your address, city, state, and ZIP code.

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