Form G-17 - Resale Certificate General Form 1 - 1989
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1FORM G-17
(REV. 1989)
STATE OF HAWAII ---- DEPARTMENT OF TAXATION
RESALE CERTIFICATE
GENERAL FORM 1
(For use where the Purchaser is to give only one Certificate to the Seller.)
To
(Name of Seller)
(Address of Seller)
(Date of this Certificate)
(City)
(State)
(ZIP Code)
The undersigned hereby certifies the following as Purchaser or for the below named Purchaser, pursuant to section 237-13(2)(F) of the General
Excise Tax Law, Chapter 237, Hawaii Revised Statutes, as amended, and Title 18 Rules of the Director of Taxation Relating to Resale Certificates
and Sales at Wholesale:
That the Purchaser is the holder of Hawaii G.E./Use Identification No. ___________________________________ under the General Excise
Tax Law.
That the nature and character of the Purchaser’s business is
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
That until this Certificate is revoked by notice in writing it shall apply to all sales of tangible personal property which the Purchaser shall
purchase from the Seller named above, except those orders as to which the Purchaser shall specify by notice in writing that this Certificate does not
apply.
That all of the sales of tangible personal property to which this Certificate applies shall be sales at wholesale as provided by section 237-4, HRS.
(Name of Purchaser)
(Address of Purchaser)
(Type of Organization, e.g., corporation, partnership, individual)
(Signature of person signing this Certificate for the Purchaser, and
)
title, or source of authority
Seller should retain this Certificate for Seller’s files. Do not send to the Department of Taxation.
FORM G-17
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