Multi-State Tax Exempt Form

UNIFORM SALES & USE TAX RESALE CERTIFICATE — MULTIJURISDICTION
The below-listed states have indicated that this certificate is acceptable as a resale/exemption certificate for sales/use tax, subject to the instructions and notes on pages 2─6. The issuing Buyer and the recipient Seller have the responsibility to determine the proper use of this certificate under applicable laws in each state, as these may change from time to time. This form was revised as of October 14, 2022.

Click here if you need the tax exempt form for the state of Indiana
Issued to Seller: SIOUX CITY TARP, INC

Address: 5201 Harbor Drive Sioux City, Iowa 51111
I certify that: Name of Firm (Buyer):*
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
May we text you at this number (no spam)?*

YesNo
Would you like us to create a tax-exempt online shopping account for you at siouxcitytarp.com (pending approval of this form)?*

YesNo
We’ll use the contact info from this form to create your siouxcitytarp.com account and text you login instructions.
We’ll use the contact info from this form to create your siouxcitytarp.com account and email you login instructions.
Buyer is engaged or is registered as a:*

WholesalerRetailerManufacturerSellerLessor (see notes on pages 2-4)Other
and is registered for sales/use tax with the below-listed states and cities within which Seller would deliver purchases to Buyer and that any such purchases are for wholesale, resale, or ingredients or components of a new product or service to be resold, leased, or rented in the normal course of business. Buyer is in the business of wholesaling, retailing, manufacturing, leasing (renting), or selling the following:
Description of Business:*
General description of tangible property or taxable services to be purchased from the Seller:*
Do not enter your social security number on this form.
Choose the purchaser's state of registration, seller's permit, or ID of Purchaser and complete form:*
If you do not have a state registration number, just choose the state you live in from the dropdown and type N/A into the required field.
Alabama
State Registration, Seller’s Permit, or ID Number of Purchaser
Alaska
State Registration, Seller’s Permit, or ID Number of Purchaser
Arizona
State Registration, Seller’s Permit, or ID Number of Purchaser
Arkansas
State Registration, Seller’s Permit, or ID Number of Purchaser
California
State Registration, Seller’s Permit, or ID Number of Purchaser
Colorado
State Registration, Seller’s Permit, or ID Number of Purchaser
Connecticut
State Registration, Seller’s Permit, or ID Number of Purchaser
Florida
State Registration, Seller’s Permit, or ID Number of Purchaser
Georgia
State Registration, Seller’s Permit, or ID Number of Purchaser
Hawaii
State Registration, Seller’s Permit, or ID Number of Purchaser
Idaho
State Registration, Seller’s Permit, or ID Number of Purchaser
Illinois
State Registration, Seller’s Permit, or ID Number of Purchaser
Iowa
State Registration, Seller’s Permit, or ID Number of Purchaser
Kansas
State Registration, Seller’s Permit, or ID Number of Purchaser
Kentucky
State Registration, Seller’s Permit, or ID Number of Purchaser
Maine
State Registration, Seller’s Permit, or ID Number of Purchaser
Maryland
State Registration, Seller’s Permit, or ID Number of Purchaser
Michigan
State Registration, Seller’s Permit, or ID Number of Purchaser
Minnesota
State Registration, Seller’s Permit, or ID Number of Purchaser
Missouri
State Registration, Seller’s Permit, or ID Number of Purchaser
Nebraska
State Registration, Seller’s Permit, or ID Number of Purchaser
Nevada
State Registration, Seller’s Permit, or ID Number of Purchaser
New Jersey
State Registration, Seller’s Permit, or ID Number of Purchaser
New Mexico
State Registration, Seller’s Permit, or ID Number of Purchaser
North Carolina
State Registration, Seller’s Permit, or ID Number of Purchaser
North Dakota
State Registration, Seller’s Permit, or ID Number of Purchaser
Ohio
State Registration, Seller’s Permit, or ID Number of Purchaser
Oklahoma
State Registration, Seller’s Permit, or ID Number of Purchaser
Pennsylvania
State Registration, Seller’s Permit, or ID Number of Purchaser
Rhode Island
State Registration, Seller’s Permit, or ID Number of Purchaser
South Carolina
State Registration, Seller’s Permit, or ID Number of Purchaser
South Dakota
State Registration, Seller’s Permit, or ID Number of Purchaser
Tennessee
State Registration, Seller’s Permit, or ID Number of Purchaser
Texas
State Registration, Seller’s Permit, or ID Number of Purchaser
Utah
State Registration, Seller’s Permit, or ID Number of Purchaser
Vermont
State Registration, Seller’s Permit, or ID Number of Purchaser
Washington
State Registration, Seller’s Permit, or ID Number of Purchaser
Wisconsin
State Registration, Seller’s Permit, or ID Number of Purchaser
I further certify that if any property or service so purchased tax-free is used or consumed by Buyer so as to make it subject to sales/use tax, Buyer will pay the tax due directly to the proper taxing authority when state law so provides or inform the Seller for added tax billing. This certificate shall be a part of each order that Buyer may hereafter give to Seller, unless otherwise specified, and shall be valid until canceled by Buyer in writing or revoked by the city or state.

Under penalties of perjury, I swear or affirm that the information on this form is true and correct as to every material matter.
Authorized Signature*

Clear
(Owner, Partner, or Corporate Officer, or other authorized signer of Buyer)
Title*
Date*

MonthDayYear
Date
Should be Empty: