5755 granger road, suite 900, independence, oh 44131 phone: 800
TRANSCRIPT
5755 Granger Road, Suite 900, Independence, OH 44131Phone: 800-284-7357 Email: [email protected]: www.SupplySideUSA.com
20101022 Open Terms Application Page 1 of 3
20101022 Open Terms Application
5755 Granger Road, Suite 900, Independence, OH 44131 Phone: 800-284-7357 or 800-305-6110
Fax: 800-955-2697
RESALE CERTIFICATE DOCUMENT
State of _____________________________________________
_______________________________________________________________________________________________
(Name of Purchaser) _______________________________________________________________________________________________
(Address of Purchaser) I HEREBY CERTIFY: that I hold valid seller’s permit No. ________________________________ (For states that do not charge sales tax, use EIN or Social Security Number – FILL IN ABOVE). issued pursuant to the Sales and Use Tax Law; that I am engaged in the business of selling _______________________________________________________________________________________________; that the tangible personal property described herein which I shall purchase from: Supply Side USA, Inc., 5575 Granger Road, Suite 900, Independece, OH 44131 will be resold by me in the form of personal property; provided, however, that in the event any such property is used for any purpose other than retention, demonstration, or display while holding it for sale in the regular course of business, it is understood that I am required by the Sales and Use Tax Law to report and pay tax, measured by the purchase price of such property or other authorized amount. Description of property to be purchased: ______________________________________________________________________________________________ ______________________________________________________________________________________________ Date: ______________________________ Signature of Purchaser or Authorized Agent: __________________________________________________________ Please print name: _______________________________________________________________________________ Title: __________________________________________________________________________________________
Page 3 of 320101022 Open Terms Application