SALES AND USE TAX EXEMPTION CERTIFICATE

      Check One       □ Single Purchase         □ Continuous

      Name of purchaser: ___________________________________________

Purchaser’s Business Name

Purchaser’s Address

Purchaser’s Email Address

Purchaser’s Phone Number

      The above purchaser, claims exemption from state, county, or use tax on the purchase of tangible personal

      property or taxable  services.

      I hereby certify that I am engaged in the business of selling or providing services: 

       _____________________________________________________________________________

       _____________________________________________________________________________

      (Description of Property or Services Sold by Purchaser)

 

       General description of property or services purchased; Pure Essential Oils and accessories.

Seller’s Name

 Kelley Pure Essential Oils

Seller’s Address

404 W 5th Street

New Richmond, WI 54017

kelleyoils@gmail.com

 

       Purchaser’s seller’s permit or use tax certificate number if available; _______________________

       I hereby certify that if the item(s) being purchased are not used in an exempt manner, I will remit use tax on the

       purchase price at   the time of first taxable use. I understand that failure to remit the use tax may result in a future

       liability that may include tax, interest, and penalty.

Signature of Purchaser

Print or Type Name

Title

Date