Tax Exemption Certificate

Firm Name: Effective Date: Expiration Date: I HEREBY CERTIFY that all the tangible personal property which I will purchase from will be purchased for resale in the regular course of business, or for the purpose of consuming the property purchased in producing for sale a new article of tangible personal property of which the property purchased will be an ingredient, or a chemical used in processing the same. This certificate shall be considered a part of each order which I may hereafter give to you, unless otherwise specified, and shall be valid until revoked by me in writing. Registration Number: Name as Registered: Address: Dated: Type of Business: Authorized Signature: Title: All blanket resale certificates must be renewed at intervals not to exceed four years Tax Exemption Certificate American LegalNet, Inc. www.FormsWorkFlow.com 2001 © American LegalNet, Inc.