SALES AND USE TAX EXEMPTION CERTIFICATE Check One □ Single Purchase □ Continuous Name of purchaser: ___________________________________________
Purchaser’s Business Name | Purchaser’s Address
Purchaser’s Email Address | Purchaser’s Phone Number
The above purchaser, claims exemption from state, county, or use tax on the purchase of tangible personal property or taxable services. I hereby certify that I am engaged in the business of selling or providing services: _____________________________________________________________________________ _____________________________________________________________________________ (Description of Property or Services Sold by Purchaser) General description of property or services purchased; Pure Essential Oils and accessories.
Seller’s Name Kelley Pure Essential Oils | Seller’s Address 404 W 5th Street New Richmond, WI 54017 kelleyoils@gmail.com
Purchaser’s seller’s permit or use tax certificate number if available; _______________________ I hereby certify that if the item(s) being purchased are not used in an exempt manner, I will remit use tax on the purchase price at the time of first taxable use. I understand that failure to remit the use tax may result in a future liability that may include tax, interest, and penalty.
Signature of Purchaser | Print or Type Name | Title | Date