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RESALE CERTIFICATE Check Applicable Block

Important CERTIFICATE not valid unless CERTIFICATEC heck Applicable BlockBlanket Single purchase Name of Business AddressCAUTION TO SELLER: Contractors or other persons registered under a consumer number in the 900,000 series may not issue a RESALE CERTIFICATE for any purchase . Sellers accepting certificates from such persons will be held liable for the sales or use : Any person who makes improper use of this CERTIFICATE is subject to such penalties as provided by law including the criminal provisions of KRS (1). Authorized Signature (Owner, Partner or Corporate Officer) Title Date I hereby certify that _____holds a valid Sales and Use Tax Permit, Account No.

Blanket Single Purchase Name of Business Address CAUTION TO SELLER: Contractors or other persons registered under a consumer number in the 900,000 series may not issue a resale certificate for any purchase. Sellers accepting certificates from such persons will be held liable for the sales or use tax.

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