Form As 2917.1 - Application For Duplicate Of Sales And Use Tax Certificates And Waivers - 2013

ADVERTISEMENT

Form AS 2917.1
Commonwealth of Puerto Rico
Rev. Oct 10 13
DEPARTMENT OF THE TREASURY
APPLICATION FOR DUPLICATE OF SALES AND USE TAX
CERTIFICATES AND WAIVERS
Merchants’ Registration Number:
1. Legal name of the corporation, partnership, individual owner (name, initial, last name) or other
2. Trade name or “DBA”
3. Type of duplicate requested:
Merchant’s Registration Certificate
Exemption Certificate
Reseller Certificate
Eligible Reseller Certificate
Eligible Wholesaler Waiver
Manufacturer Waiver
4. Indicate the reason for requesting a duplicate:
A. Merchant’s Registration Certificate -
Theft
Destruction
Loss
Other ________________________________
B. Exemption Certificate -
Theft
Destruction
Loss
Other ________________________________
C. Reseller Certificate -
Theft
Destruction
Loss
Other ________________________________
D. Eligible Reseller Certificate -
Theft
Destruction
Loss
Other ________________________________
E. Eligible Wholesaler Waiver -
Theft
Destruction
Loss
Other ________________________________
F. Manufacturer Waiver -
Theft
Destruction
Loss
Other ________________________________
OATH
I hereby declare under penalties of perjury that this application has been examined by me, and that to the best of my knowledge and belief, all
the information provided herein is true, correct and complete. The declaration of the person that prepares this application (except the
merchant) is with respect to the available information, and such information has been verified.
Merchant’s name
Merchant’s signature
Title
Date
Date
Name of the authorized agent
Signature of the authorized agent
Address
Telephone
Social security or employer identification number
(
)
Retention: Six (6) years.

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 2