Form C-6060-Mf - New Jersey Tax Exemption Certificate On Motor Fuel Sales To State, County Or Local Governments

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NEW JERSEY TAX EXEMPTION CERTIFICATE ON MOTOR FUEL SALES
C-6060-MF
TO STATE, COUNTY OR LOCAL GOVERNMENTS
(see instructions on reverse side)
Motor fuels sold to ______________________________________________________________________________________
(SHOW NAME AND ADDRESS OF SPECIFIC NEW JERSEY GOVERNMENT AGENCY)
I certify that I have purchased for the exclusive use of the Government Agency noted above from
______________________________________________________________________________________________________
(NAME AND ADDRESS OF VENDOR)
(DELIVERED AT)
on _____________________________
____________________________________________________________________
(DATE)
(SHOW TOTAL FUEL GALLONS AND TOTAL TAX EXCLUDED)
on purchases which had been delivered and invoiced pursuant to purchase orders, and for which a tax exemption has not been
heretofore issued.
__________________
__________________________________________________
_________________________
Date
Signature and Title of Officer
Vehicle License Number
NJ D
T
, PO B
243, T
, NJ 08695-0243
IVISION OF
AXATION
OX
RENTON

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