Form St-5c - Contractor'S Sales Tax Exempt Purchase Certificate Page 2

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Part D. Location and description of project
Part E. Description of kind and quantity of property purchased
Date
Description
Quantity
Cost
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Total cost
$
Additional information about the use of this form may be obtained by calling the Customer Service Bureau at (617) 887-MDOR or
toll-free, in Massachusetts, 1-800-392-6089.
printed on recycled paper

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