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North Carolina Tax Forms

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					CERTIFICATION CONCERNING NORTH CAROLINA SALES & USE TAX

We certify that on the ___________________________ project for _______________________
(Owner, in ____________________ County, North Carolina that the Sales Tax or Use Tax on
accounts in the amounts listed and itemized below was paid by______________________________
and that the materials purchased were used in the construction and became a component of the
above referenced project.



                                                    ____________________________________
                                                               Authorized Signature

Subscribed to before me in my presence. Witness, my hand and seal given this _______day of
__________________, 2008, City of _____________________________ , NC


____________________________    _____________________
Notary Public                   My Commission Expires


                Invoice                 Invoice
     Invoice No Date      Vendor        Amount     Total Tax   State Tax   County Tax

				
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