Please click here if you are not Sales Tax Exempt.

Sales Tax will be added to your invoice, when applicable.

Sales Tax Exempt Certificate

MULTI-JURISDICTION

SALES TAX EXEMPTION CERTIFICATE

ISSUED TO:  ADDRESS:CITY:          STATE:         ZIP:

CENTRI COATINGS & SYSTEMS CORP    1010 Gentry      NKC     MO  64116   

Section I

     

Name of Firm (Buyer)

Street Address or PO Box Number:

City

State:

Zip Code:

Section II

Buyer is engaged as a registered:

Section III

Buyer is registered with the below listed state and cities within which CENTRI COATINGS would deliver purchases to Buyer and that any such purchase are for wholesale, resale, ingredients, or components of a new product to be resold, leased, or rented in the normal course of our business.  Buyer is in the business of wholesaling, retailing, manufacturing, leasing or renting.

Product or Services Rendered

State:

State ID Number:

I further certify that if any property so purchase tax free is used or consumed by the firm as to make it subject to a Sales 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.

General description of products to be purchased from the seller:

I swear or affirm that the information on this form is true and correct as to every material matter.  Please note: Name entered below is accepted as temporary electronic signature.

Authorized Signature (Owner, Partner, or Corporate Officer)          Title          Date

-State-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisiannaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

-pick one-   WholesalerRetailerManufacturerLessorOther -enter below-

-State-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisiannaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming