Chandler Exemption Certificate Form printable pdf download

Chandler Exemption Certificate Form

CHANDLER EXEMPTION CERTIFICATE

INVALID UNLESS COMPLETED IN FULL

VENDOR’S NAME ______________________________________ Sales Invoice No:__________________

Customer’s Exemption Claim

City of Chandler Privilege License (Sales) Tax

Customer’s Business Name: ________________________________________________________________

Customer’s Business Address: _______________________________________________________________

Specific Business Activity:

___________________________________________

(E.g., if retailer, lessor or manufacturer,

___________________________________________

specify items leased, sold or made i.e., cars,

computers, etc.)

___________________________________________

Customer’s License No’s. City: ______________________ State: ________________

ITEMS CLAIMED AS EXEMPT FROM TAX

_______ All items on this invoice or purchase order

_______ Only those items marked with an "E".

REASON FOR CLAIMED EXEMPTION:

_______ The items claimed as exempt are sold, rented, leased, or licensed by the above named customer in the normal course of its

business activity.

_______ The items claimed as exempt are exempt from the City of Chandler Privilege Tax for the following specific reason(s):

______________________________________________________________________________________________

CUSTOMER’S CERTIFICATE

I certify that the above information is accurate to the best of my information and belief, and that I am authorized by the Customer above

to acquire the items claimed as exempt on a tax-free basis on its behalf. I further understand that the making of a false or fraudulent

claim to obtain a tax exemption is a Class One Misdemeanor under Chandler City Code Section 15-1.

______________________________

__________________________

______________________________

Name

Date

Title

Chandler Exemption Certificate Form