Form St-75 - Sales And Use Tax Returns E-File Program - Enrollment Form And Certifications Page 2
ADVERTISEMENT
1
2
3
4Page 2 of 4 ST-75 (7/01)
Acknowledgment or witnessing of the taxpayer certification (required)
This Taxpayer certification must be acknowledged before a notary public or witnessed by two disinterested individuals.
The person signing on page 1 as the taxpayer appeared before us and executed this Taxpayer certification.
Name of first witness
Date
Name of second witness
Date
(please type or print)
(please type or print)
Signature of first witness
Signature of second witness
Mailing address of first witness
Mailing address of second witness
(please type or print)
(please type or print)
Acknowledgment — individual
Acknowledgment — corporate
State of
ss:
State of
ss:
County of
County of
On this
day of
,
,
On this
day of
,
,
before me personally came,
before me personally came,
to me known, who, being by me duly sworn, did say that he/she
to me known to be the person(s) described in the foregoing Taxpayer
resides at
(insert address)
;
certification; and he/she/they acknowledged that he/she/they
that he/she is the
of
executed the same.
, the corporation described in the foregoing
Taxpayer certification; and that he/she/they signed his/her/their
name(s) thereto by authority of the board of directors of said
corporation and that he/she/they knows the seal of said corporation;
that the seal affixed to such Taxpayer certification is such corporate
seal; that it was so affixed by order of the board of directors.
Signature of notary public
Date
Signature of notary public
Date
Notary public: affix stamp (or other indication of notary’s authority).
Notary public: affix stamp (or other indication of notary’s authority).
Acknowledgment — limited liability company
Acknowledgment — partnership/LLP
State of
ss:
State of
ss:
County of
County of
On this
day of
,
,
On this
day of
,
,
before me personally came,
before me personally came,
to me known, who, being by me duly sworn, did say that he/she/they/it
to me known, who, being by me duly sworn, did say that
reside(s) at
(insert address)
;
he/she/they/it reside(s) at
(insert address)
;
that he/she/they is (are) a member(s) or manager(s) of
,
that he/she/they is (are) a partner(s) of
,
the limited liability company described in the foregoing Taxpayer
the partnership described in the foregoing Taxpayer certification; and
certification; and that he/she/they is (are) empowered to and did
that he/she/they is (are) empowered to and did execute the same.
execute the same.
Signature of notary public
Date
Signature of notary public
Date
Notary public: affix stamp (or other indication of notary’s authority).
Notary public: affix stamp (or other indication of notary’s authority).
Acknowledgment — partnership by its corporate general partner
State of
ss:
County of
On this
day of
,
,
before me personally came,
to me known, who, being by me duly sworn, did say that he/she/they/it
reside(s) at
(insert address)
;
that he/she is the
of,
(name of corporate general partner), that
executed the foregoing Taxpayer certification; in its capacity as the
general partner of
(name of partnership), described in
the foregoing Taxpayer enrollment; for and on behalf of the partnership;
that he/she knows the corporate seal of such corporation/general partner;
that the seal affixed to such Taxpayer certification is such corporate seal;
that it as so affixed by order of the board of directors of such corporation,
and he/she signed his/her name thereby by like order.
Signature of notary public
Date
Notary public: affix stamp (or other indication of notary’s authority).
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial