Independent Printing - Certificate of Resale

. I N D E P E N D E N T . P R I N T I N G

Certificate of Resale

Please print out
this form, execute,
and mail back to:
Independent Printing
Attn: Accounting
500 Mason Ave.
Daytona Beach, FL
32117

Or Fax to:
(904) 254-0657

Thank you.
This is to certify that all tangible personal property and services purchased by the undersigned from you will be purchased for use as follows:

[1] For resale as tangible personal property in the same form as received from you; or,

[2] To be incorporated as a material or parts of other tangible personal property to be produced for sale, manufacturing, assembling, processing and/or refining; or,

[3] Any natural or artificial gas, oil, electricity, solid fuel or stream purchased from you will be used in manufacturing assembling, processing, or refining.

This Certificate shall be considerd a part of each order which we place with you; provided that each order will contain our Certificate of Registration number (or Specific Exemption Certificate number) followed by the applicable number(s) from this certificate - [1], [2], [3] - to specify which of the items listed above are covered by each order.

This certificate shall continue in force until revoked by notice to you in writing.

Please select
(from above): [1] [2] [3]

Name of Purchaser:

By (person):

Corporate Tax/ Manager Reg'n. No.:

By submitting this Certificate of Resale, I certify that the above information is true and correct.

Signature: Date:

Please print out this form, execute, and mail back to: Independent Printing Attn: Accounting 500 Mason Ave. Daytona Beach, FL 32117 Or Fax to: (904) 254-0657 Thank you.	This is to certify that all tangible personal property and services purchased by the undersigned from you will be purchased for use as follows: [1] For resale as tangible personal property in the same form as received from you; or, [2] To be incorporated as a material or parts of other tangible personal property to be produced for sale, manufacturing, assembling, processing and/or refining; or, [3] Any natural or artificial gas, oil, electricity, solid fuel or stream purchased from you will be used in manufacturing assembling, processing, or refining. This Certificate shall be considerd a part of each order which we place with you; provided that each order will contain our Certificate of Registration number (or Specific Exemption Certificate number) followed by the applicable number(s) from this certificate - [1], [2], [3] - to specify which of the items listed above are covered by each order. This certificate shall continue in force until revoked by notice to you in writing.
Please select (from above):	[1] [2] [3]
Name of Purchaser:
By (person):
Corporate Tax/ Manager Reg'n. No.:

	By submitting this Certificate of Resale, I certify that the above information is true and correct.
Signature:	Date: