Exemption Certificate For Sales To Native Americans Or Tribal Councils Form (Page 2 of 2) in pdf

Exemption Certificate For Sales To Native Americans Or Tribal Councils Form Page 2

Purchaser Identification:

Enrolled Member Name

________________________________________________________________

Tribal ID Card Number

________________________________________________________________

Tribe Name

________________________________________________________________

Site of Delivery

________________________________________________________________

I (print Purchaser’s full name) _______________________________________ certify that for the purpose of the

exemption claimed that the foregoing information is true, accurate, and complete. I further understand that the

making of a false or fraudulent claim to obtain a tax exemption is a Class One Misdemeanor under Tempe City

Code Section 16-580.

_______________________________________

________________________________

(Purchaser’s Signature)

(Date)

I (print Seller’s full name) _______________________________________ certify that for the purpose of the

exemption claimed that the foregoing information is true, accurate, and complete. I further understand that the

making of a false or fraudulent claim to obtain a tax exemption is a Class One Misdemeanor under Tempe City

Code Section 16-580.

_______________________________________

________________________________

(Seller’s Signature)

(Date)

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Exemption Certificate For Sales To Native Americans Or Tribal Councils Form Page 2