Tax Exempt Sale Affidavit Page 4

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City of Pueblo – Sales Tax Division
• Please check the box for the picture that matches the credit card used to make the purchase.
• Copy and write in the first six digits and the last four digits from the credit card used to make the purchase.
• DO NOT WRITE THE COMPLETE ACCOUNT NUMBER.
Account number _ _ _ _ - _ _ XX- XXXX - _ _ _ _
Account number _ _ _ _ - _ _ XX- XXXX - _ _ _ _
Account number _ _ _ _ - _ _ XX- XXXX - _ _ _ _
Account number _ _ _ _ - _ _ XX- XXXX - _ _ _ _

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