| Tax Exemption Certificate Page 3 of 3 | Form 149 (Rev. 4-88) | SEE BELOW FOR INSTRUCTIONS |
| ISSUED TO DuraComm Corporation |
ADDRESS 203 West 23rd Avenue |
CITY, STATE, ZIP CODE North Kansas City, Missouri 64116 |
| NAME OF FIRM (BUYER) |
ENGAGED AS A REGISTERED: WHOLESALE RETAILER MANUFACTURER LESSOR (*SEE NOTE BELOW) OTHER_____________________________ |
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| STREET ADDRESS OR
P.O. BOX NUMBER |
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| CITY, STATE, ZIP
CODE |
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| The above named firm 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, ingredients or components of a new product to be resold, leased, or rented in the normal course of our business. We are in the business of wholeselling, retailing, manufacturing, leasing, or renting. | ||
| PRODUCT OR SERVICES
RENDERED |
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| STATE |
STATE I.D. NUMBER |
CITY OR STATE |
STATE REGISTRATION
OR I.D. NUMBER |
| CITY OR STATE |
STATE REGISTRATION
OR I.D. NUMBER |
CITY OR STATE |
STATE REGISTRATION
OR I.D. NUMBER |
| CITY OR STATE |
STATE REGISTRATION
OR I.D. NUMBER |
CITY OR STATE |
STATE REGISTRATION
OR I.D. NUMBER |
| I further certify that if any property so purchased tax free is used or consumed by the firm as to make it subject to a State or Use Tax we will pay the tax due direct to the proper taxing authority when state law so provides or inform the seller for added tax billing. This certificate shall be part of each order which 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. | |||
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GENERAL DESCRIPTION OF PRODUCTS
TO BE PURCHASED FROM THE SELLER |
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I swear or affirm that the information on this form is true and correct as to every material matter. |
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| AUTHORIZED SIGNATURE (OWNER, PARTNER OR CORPORATE OFFICER)
TITLE
DATE |
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TO OUR CUSTOMERS: In order to comply with
the majority of state and local sales tax law
requirements it is necessary that we have in our files a properly executed
exemption certificate from all of our customers who claim sales tax exemption.
If we do not have this certificate, we are obligated to collect the tax for the
state in which the property is delivered. |
| Alabama | Maryland | South Carolina | ||
| Alaska | Michigan | South Dakota | ||
| Arkansas | Minnesota | Texas | ||
| District of Columbia | Missouri | Utah | ||
| Georgia | Nevada | Vermont | ||
| Idaho | New Mexico | Virginia | ||
| Illinois | North Dakota | Washington | ||
| Maine | Oklahoma | Wisconsin | ||
| Rhode Island | ||||
| NOTE: ILLINOIS DOES NOT HAVE
AN EXEMPTION ON SALES OF PROPERTY FOR SUBSEQUENT LEASE OR RENTAL. CAUTION TO SELLER: In order for the certificate to be accepted in good faith by the seller, the seller must exercise care that the property being sold is of a type normally sold wholesale, resold, leased, rented, or utilized as an ingredient or component part of a product manufactured by the buyer in the usual course of his business. A seller failing to exercise due care could be held liable for the sales tax due in some states or cities. Misuse of this certificate by the seller, lessor, buyer, lessee, or the representative thereof may be punishable by fine, imprisonment or the loss of right to issue certificates in some states or cities. |
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IMPORTANT: ACCOUNT WILL NOT BE
PROCESSED WITHOUT LEGALLY AUTHORIZED SIGNATURE AND |