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Wisconsin Tax Exempt Form


Wisconsin Tax Exempt Form document sample

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									                       Wisconsin Sales and Use Exemption Certificate

Please check below

Single Purchase _________________ Continuous ____________

Purchaser’s Name _______________ ____________________

Purchaser’s Address _____________ ____________________

Upon signing the bottom of this form, the purchaser claims exemption from Wisconsin State,
County, Sales, and Use tax on the purchase, rental, or lease of tangible personal property or
taxable services, according to the information on this form.

Permit or tax certificate number _____________________________

Please check the line that applies to purchaser

Manufacturing _______________

Wholesaler __________________

Distributor __________________

Retailer _____________________


I hereby certify that I am engaged in the business as stated on this form

                           (Description of Property or Services Sold by Purchaser)

                        Sellers Name                                 Sellers Address
             Midwest Metal Warehouse LLC                    W147 N9415 Held Drive
                                                           Menomonee Falls, WI 53051

By signing this form, I certify that the item(s) purchased will be used in an exempt manner, and if
 not, will remit use tax at the time of first taxable use. I understand that failure to remit tax may
                result in a future liability that may include tax, interest and penalty.

                Authorized Signature___________________________________

                Title _____________________________________ Date____________

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