Application For ST-5 Exempt Organization Certificate Nonprofit Exemption Sales Tax

<document>COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)State of New Jersey DEPARTMENT OF THE TREASURY DIVISION OF REVENUE PO Box 628 TRENTON, NJ 08646-0628John E. McCormac, CPA State Treasurer James E. McGreevey Governor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .In keeping with New Jersey's %22One Stop Shopping%22 initiative, the Division of Revenue has expanded the EFT Program to include Unemployment, Disability, Workforce Development, and Health Care contributions previously sent to the Department of Labor. While making Employer Withholding payments is still mandatory for some employers; the use of EFT for these payments is voluntary for all employers. As an ACH Debit participant in the EFT Program, you know that the Division can not debit an account without proper authorization. Attached is a modified enrollment form for this payment type for you to complete and return to the Division. This will allow you to begin making these payments in addition to your Employer Withholding payments. If you wish to take advantage of EFT for this payment type, please complete and return the form, with the required attached document(s) to the Division as soon as possible. Please attach the required voided check or other form of bank verification for the indicated account. We will then forward the payment codes and addendum information.If you have any questions you may contact the EFT Unit at (609) 984-9830, fax (609) 292-1777or visit our web site at www.state.nj.us/treasury/revenue.THE PEOPLE OF THE STATE OF NEW YORK TOGREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomYour failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply., one of the Justices of theTaxpayer ID #: - - /Type: UI/DICourt in Witness, Honorableday of, 20 County,Taxpayer Name (Attorney must sign above and type name below) Transit/Routing NumberBank Account Number Contact NameAttorney(s) forTitle SignatureTelephone #Office and P.O. AddressReturn to: New Jersey Division of Revenue, EFT Unit, POB 191, Trenton, NJ 08646-0191Telephone No.: Facsimile No.: E-Mail Address:New Jersey Is An Equal Opportunity Employer Printed on Recycled and Recyclable PaperMobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com</document>