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Company Location

By checking this box you are stating you agree to the Terms and Conditions herein (US Terms and conditions)

Primary Billing Address

Business Name

Telephone

Street Address

Country

State/Province

ZIP/Postal Code

City

California Resale Certificate

I HEREBY CERTIFY:

1. I hold a valid seller's permit number:

2. I am engaged in the business of selling the following type of tangible personal property:

3. This certificate is for the purchase from

of the item(s) I have listed in paragraph 5 below.

4. I will resell the item(s) listed in paragraph 5, which I am purchasing under this resale certificate in the form of tangible personal property in the regular course of my business operations, and I will do so prior to making any use of the item(s) other than demonstration and display while holding the item(s) for sale in the regular course of my business. I understand that if I use the item(s) purchased under this certificate in any manner other than as just described, I will owe use tax based on each item’s purchase price or as otherwise provided by law.

5. Description of property to be purchased for resale:

6. I have read and understand the following:
For Your Information: A person may be guilty of a misdemeanor under Revenue and Taxation Code section 6094.5 if the purchaser knows at the time of purchase that he or she will not resell the purchased item prior to any use (other than retention, demonstration, or display while holding it for resale) and he or she furnishes a resale certificate to avoid payment to the seller of an amount as tax. Additionally, a person misusing a resale certificate for personal gain or to evade the payment of tax is liable, for each purchase, for the tax that would have been due, plus a penalty of 10 percent of the tax or $500, whichever is more.

Name of Purchaser

Signature)

Printed name of person signing

Title

Address of Purchaser

Street Address

* PO BOX addresses will be rejected

ZIP/Postal Code

State/Province

City

Same as Billing Address

Telephone

Date

Primary Shipping Address

Same as Billing Address

Street Address

Country

State/Province

ZIP/Postal Code

City

UPS Account Number

FedEx Account Number

Multi State Resale Certificate

UNIFORM SALES & USE TAX EXEMPTION/RESALE CERTIFICATE -- MULTIJURISDICION

Issued to Seller:

Seller Address

Street

State

City

Postalcode

Same as Billing Address

I certify that:

Name of Firm (Buyer):

Buyer Address

Street

State

City

Postalcode

Same as Billing Address

is engaged as a registered

Specify

and is registered with the below-listed states and cities within which your firm would deliver purchases to us and that any such purchases are for wholesale, resale, or ingredients or components of a new product or service to be resold, leased, or rented in the normal course of business. We are in the business of wholesaling, retailing, manufacturing, leasing (renting) selling (California) the following:

Description of Business:

General description of tangible property or taxable services to be purchased from the Seller:

State

State Registration, Seller's Permit, or ID Number of Purchaser

I further certify that if any property or service so purchased tax free is used or consumed as to make it subject to a Sales or Use Tax we will pay the tax due directly to the proper taxing authority when state law so provides or inform the Seller for added tax billing. This certificate shall be a part of each order that we may hereafter give to you, unless otherwise specified, and shall be valid until canceled by us in writing or revoked by the city or state.
Under penalties of perjury, I swear or affirm that the information on this form is true and correct as to every material matter.

Authorized Signature (Owner, Partner, or Corpotate Officer, or other authorized signer)

Title

Date

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Payment Information

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Primary Billing Address

California Resale Certificate

Primary Shipping Address

UNIFORM SALES & USE TAX EXEMPTION/RESALE CERTIFICATE -- MULTIJURISDICION

Seller Address

Buyer Address

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