SALES AND USE TAX CERTIFICATE
MULTI - JURISDICTIONAL
Issued to (Seller)
I certify that the below listed firm (Buyer)
Young Electric Sign Company
is engaged as a registered ( please check one)
Retailer
Wholesaler
Manufacturer
and is registered with the following listed states which your firm would deliver purchases to us and that any
such purchases are for wholesale, resale, or components of a new product to be resold in the normal course
of our business.
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 Sale or Use Tax, I 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 state.
General description of products to be purchased from the seller include:
Raw materials used in manufacturing illuminated signs, i.e. sheet metal, ballast, lighting, paint, etc..
I declare under the penalties of false statement that this certificate has been examined by me and to the best
of my knowledge and belief is true, correct, and complete.
Authorized Signature
(Name)
State
AZ
AR
CA
CO
FL
ID
IL
IN
IA
LA
MI
MS
Registration Number
08 004327-F
302878-76-001
SZ0H30609812
01-68074-0000
78-8013802060-1
154955
2497-3076
119685108
2-00-151039
8618704001
87-0212261
024-27207-2
(Title)
State
MO
NV
NM
OK
PA
SD
TN
TX
UT
WA
WY
3/6/2016
(Date)
Registration Number
16305515
001-TX-1001316681-001
01-864876-002
868400
83-130778
73-001-870212261E-ST-001
101750072
1-87-0212261-7
12278466-002-STC
600084396
24000471