Michigan Sales And Use Tax Certificate Of Exemption Form March 2000 (Page 2 of 2) in pdf

Michigan Sales And Use Tax Certificate Of Exemption Form March 2000 Page 2

Sales and Use Tax Exemptions and Requirements

Page 5 of 5

Non-Profit Organizations

____Government Entity, Nonprofit School, Nonprofit Hospital, and Church

(circle type of organization)

____Internal Revenue Code Section 501(c)(3) and 501(c)(4) Organizations

____Exempt letter from the State of Michigan

____Other (explain):_______________________________________________

Section 4: Certification:

In the event this claim is disallowed, the purchaser promises to reimburse the seller for the amount of tax involved.

Purchaser _____________________________________

Street Address____________________________________________________

Area Code / Telephone No. _____________________________________

City State Zip Code _____________________________________________________

Signature and Title Date Signed ___________________________________________________________

Name (Print or Type) _________________________________________________________

1A blanket certificate is valid for three years from date of signature unless an earlier expiration date is listed below:

Expiration date, if less than three years: _______________ .

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Michigan Sales And Use Tax Certificate Of Exemption Form March 2000 Page 2