Agreement Purchaser Sales Use Tax Exemption Certificate

Dealer Sales/Use Tax Exemption Purchaser warrants that the Equipment will be resold in the form of tangible personal property and is therefore exempt from sales and/or use taxes, provided, however, that in the event any of such property is used for any purpose other than retention, demonstration, or display while holding it for sale in the regular course of business, it is understood that Purchaser is required by the Sales and Use tax laws to report and pay for the tax, measured by the purchase price of such property. Purchaser hereby certifies that Purchaser: 1. holds a valid sellers permit, number [N] 2. issued for the purchase of [TYPE OF EQUIPMENT OR INVENTORY OF ASSETS] or 3. under the laws of the state of [STATE] For SELLER (sign): For SELLER (sign): Print Name: Title Print Name: Date: Date: