RESALE CERTIFICATE

PLEASE FILL OUT COMPLETELY, PRINT OUT  TO ADD SIGNATURE

THEN FAX TO 818-785-3719

FIRM NAME:

I HEREBY CERTIFY, THAT I HOLD A VALID SELLER'S PERMIT NUMBER:

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:

WILL BE RESOLD BY ME IN THE FORM OF TANGIBLE 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 FOR THE TAX, MEASURED BY THE PURCHASE PRICE OF SUCH PROPERTY.

DESCRIPTION OF PROPERTY TO BE PURCHASED:

 DATED:

 SIGNATURE:

 AT:

 BY & TITLE:

 PHONE:

 ADDRESS:

Please fill out this form completely, print , sign, then fax to 818-785-3719

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