Propane Sales Tax Exemption Certificate Form
Description of property purchased under the certificate (check applicable item(s)):
Purchaser's re-sellers permit number (if applicable)*:
Purchaser's re-sellers permit is not applicable
Why are you not required to hold a permit?
* In California, you are required to hold a seller's permit if you are engaged in business of selling tangible personal property that is subject to tax when sold at retail. If you are not required to hold a seller's permit because you make no sales or leases of this type of property in California, please enter "not applicable" and the reason why you are not required to hold a permit.
Purpose for which the propane will be used (check applicable item(s)):
Name
First Name
Last Name
Title
Phone Number
-
Area Code
Phone Number
Company Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Account Number
Signature
*
Print Name
*
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: