Annual Resale Certificate for Sales Tax

* Indicates required field

President Name *

First

Last

Email *

License Number / Numero de Licencia de Conduccion *

Social Security Number/ Numero de Seguro Social *

Phone Number *

Name of Company *

Company Address *

Line 1

Line 2

City

State

Zip Code

Country

Company Number/ Numero de Documento de Inscripcion *

Entity's Fiscal Year Ending Date / Fecha de Terminacion del Fiscal Year *

Are You Hiring New Employees / Esta Contratando Nuevos Empleados? *

Describe Primary Nature of Your Business and List Activities/ Describe la Naturaleza de tu Negocio y Lista de Actividades o Productos *

Signature ( Your Name ) / Firma ( Nombre Completo) *

Date *

Agree / Acepto *

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