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Form Rev 27 - Washington Exemption Certificate For Logs Delivered To An Export Facility

Exemption Certificate for Logs Delivered

to an Export Facility

(WAC 458-20-13501)

Certificate Date/Effective Period*

Export Facility Operator

Operator UBI Number

___ ___ ___ – ___ ___ ___ – ___ ___ ___

Export Facility Location

Name of Person Giving Statement

Title of Person Giving Statement

Trucking Firm Name

Trucking Firm UBI Number

___ ___ ___ – ___ ___ ___ – ___ ___ ___

Trucking Firm Address – Street

City

State

Zip Code

The above export facility operator hereby certifies:

That ______ percentage or more of all logs hauled to the above export facility location,

_____________________ , the same located on tidewater or navigable tributaries thereto, will be

shipped by vessel directly to an out-of-state or foreign destination and the following conditions will be

met:

1. The logs will not go through a process to change the form of the logs before shipment to another

state or county.

2. There will be no intervening transportation of these logs from the time of receipt at the export facility

until loaded on the vessel for the interstate or foreign journey.

* The effective period of a certificate cannot be greater than one year.

For tax assistance visit dor.wa.gov or call 1-800-647-7706. To inquire about the availability of this document in an alternate format for

the visually impaired, please call (360) 705-6715. Teletype (TTY) users may call 1-800-451-7985.

REV 27 0045 (07/25/08)

Form Rev 27 - Washington Exemption Certificate For Logs Delivered To An Export Facility