Resale Application

In order to comply with state and local tax law requirements, it is necessary that we have, in our files, a properly executed resale certificate from all customers who claim sales tax exemption.

States AK, MT, NH, OR, and DE do not require this form as they are no tax states.

If the company resides in PA, NV, MO, OH, MA, CA, TX please fill out your state specific form instead and email it to, for all other states complete the form below.

State if you are non-exempt on this form. If you purchase tax-free for a reason not stated on this form, please provide your special certificate or statement.

Immediate return of this form will enable us to promptly serve your needs.

I Certify that

Shipping Address

Billing Address

is registered with the below listed states and cities within which your firm would deliver purchases to us and that any such purchases are for wholesale, resale, ingredients, or components of a new product to be resold, leased or rented in the normal course of our business. We are in the business of wholesaling, retailing, manufacturing, leasing or renting.

General Description of Products to Be Purchased From the Seller

List Each State and Resale Number For Multiple Ship-To Locations
State/Resale 1
State/Resale 2
State/Resale 3

If Applicable List City and City ID Number
City 1
City 2
City 3

I further cerify that if any property so purchased tax free is used or consumed by the firm as to make it subject to a SSales or Use Tax, we will pay the tax due direct to the proper taxing authority when state law so provides or inform the seller for added tax billing. This certificate shall be part of each order, which we may hereafter give you, unless otherwise specified, and shall be valid until canceled by us in writing or revoked by the city or state.

Owner, Partner, or Corporate Officer