ST-120
Your Company Name
*
Billing Address - Address
*
Billing Address - City
*
Billing Address - State
*
Billing Address - Zip
*
I am engaged in the business of
*
And principally sell
*
Jurisdictions where you are registered to collect Sales Tax
*
Write your Home State if this does not apply to you
Sales tax or VAT number(s)
*
Write your Not Applicable if this does not apply to you
Type or print name and title of owner, partner, or authorized person of purchaser
Signature of owner, partner, or authorized person of purchaser
Today's Date
/
Month
/
Day
Year
Date
Preview PDF
Submit
Should be Empty: