Sales Tax Exempt Form

To ensure the quick processing of this form, please make sure ALL fields are complete and correct.

Company Name or Organization:__________________________________________________
(Must match name on Account)

I hereby certify that I hold a valid seller's permit # or exempt # _________________________

In order for us to reference your account, please provide one or both of the following:
Sales order number (SO#):________________
Customer #:________________

The tangible personal property will be used for official government business or for wholesale, resale, or as an ingredient or component part(s) of a new product to be resold, leased, or rented in the normal course of my business.

___Government Agency ~ City, State or Federal

___Resellers ~ I further certify that if the property purchased with this certificate is used or consumed so as to make it subject to sales or use tax, I will pay the tax due directly to the appropriate taxing authority or inform the seller to add tax to the billing. This certificate shall be a part of each order that I may place with in the future, and is valid until canceled by me in writing or revoked by the city or state.

___Other sales tax exempt organization

Do you wish to be tax exempt for all future orders?
___No, I only want to be exempt for SO#___________

Description of property to be purchased:
___Computer peripherals
___Other(please specify) _____________________

Date: ____________
Print Your Name: ______________________________
Phone number: ________________________________
Signature: ____________________________________