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Puerto rico exemption form 201... Form 499 R-4. 1 Government of Puerto Rico Department of the Treasury Rev. Aug 9 11 Print Reset Form WITHHOLDING EXEMPTION CERTIFICATE READ INSTRUCTIONS ON REVERSE SIDE BEFORE COMPLETING THIS WITHHOLDING EXEMPTION CERTIFICATE Complete this form and submit it to your employer. Otherwise the employer is required to withhold your income taxes without taking into consideration your personal exemption exemption for dependents and allowance based on deductions pursuant to the Internal Revenue Code for a New Puerto Rico Code. ANY CHANGES IN THE PERSONAL EXEMPTION THE NUMBER OF DEPENDENTS OR THE ALLOWANCE BASED ON DEDUCTIONS REQUIRE THE FILING OF AN AMENDED CERTIFICATE* Employee s name FOR EMPLOYEE S USE ONLY Employee s social security number Spouse s name Spouse s social security number Home address Postal address Check here if your annual gross wages do not exceed 20 000. If you want your employer to withhold income taxes on your wages complete Part D. Otherwise proceed to sign this Certificate. None Complete Half A. PERSONAL EXEMPTION less withholding more withholding 1. Individual taxpayer. 2. Married person. 3. Additional veterans personal exemption. B. EXEMPTION FOR DEPENDENTS Number of Dependents Complete Exemption Joint Custody C. ALLOWANCE BASED ON DEDUCTIONS a Home mortgage interest. b Charitable contributions. c Medical expenses. d Interest paid on student loans at university level. e Contributions to governmental pension or retirement systems See instructions. g Educational Contributions Account. i Casualty loss on your principal residence. j Loss of personal property as a result of certain casualties. k Total deductions. 3. Number of allowances based on deductions Divide line 2 k by 500. 4. Allowances that you want to claim May be less or equal to line 3. If you are a governmental employee mark to indicate if you participate in any of the following programs See instructions Retirement Withholding Supplementary Plan Retirement Savings Accounts Program Indicate the percentage that you elected as contribution D. ELECTION FOR ADDITIONAL WITHHOLDING I authorize my employer to withhold in each payroll period the amount of or from my wages in addition to the tax required to be deducted and withheld according to the provisions of Section 1062. 01 of the Code. See instructions OATH I declare under the penalty of perjury that I have examined this form and to the best of my knowledge the information contained herein is true correct and complete. I also certify that the personal exemption exemption for dependents and the allowance based on deductions claimed herein for purposes of withholding of income tax on wages do not exceed the amount that I am entitled to claim on the income tax return according to the Code. Employee s signature Date Retention Period Six 6 years The Withholding Exemption Certificate Form 499 R-4. 1 is the document used by the employee to notify his/her employer of the personal exemption exemption for dependents and the allowance based on deductions.

Certificate fiduciary authorit... Certificate of Fiduciary Authority We, the undersigned, representing that we are all of the trustees of the Trust and that we are duly authorized by the terms of the Trust to execute and deliver this

Products updates rici total re... Transfers of securities to RBS plc pursuant to Part VII of the UK Financial Services and Markets Act 2000 On 6 February 2010 ABN AMRO Bank N.V. (registered with the Dutch Chamber of Commerce under

Indicative termsheet daimler a... Indicative Termsheet Daimler AG Coupon Certificate with 100% Redemption Strike and 60% Coupon Strike and 60% Barrier 1/3 Product Description The Daimler AG Coupon Certificate (the 'Certificate')

Cmb certificate form Estimate your FAFSA EXPECTED FAMILY CONTRIBUTION WORKSHEET This Worksheet can help you estimate how much the FAFSA's Federal Methodology Formula, used in assessing your family's eligibility for need-based

Medical examiner certificate f... Jjkeller. com Printed in the United States 651-FS-L2 MEDICAL EXAMINER S CERTIFICATE I certify that I have examined in accordance with the Federal Motor Carrier Safety Regulations 49 CFR 391. SIGNATURE OF MEDICAL EXAMINER TELEPHONE MD DATE DO Physician Assistant Chiropractor Advanced Practice Nurse DRIVER S LICENSE NO. ADDRESS OF DRIVER MEDICAL CERTIFICATE EXPIRATION DATE DISTRIBUTION 1 COPY TO THE DRIVER 1 COPY TO THE MOTOR CARRIER STATE. ALL WRITTEN OR PRINTED INFORMATION MUST BE LEGIBLE Published by J* J* KELLER ASSOCIATES INC. Neenah WI USA 800 327-6868 www. 41-391. 49 and with knowledge of the driving duties I find this person is qualified and if applicable only when wearing corrective lenses driving within an exempt intracity zone 49 CFR 391. 62 wearing hearing aid accompanied by a waiver/exemption qualified by operation of 49 CFR 391. 64 The information I have provided regarding this physical examination is true and complete. A complete examination form with any attachment embodies my findings completely and correctly and is on file in my office. SIGNATURE OF MEDICAL EXAMINER TELEPHONE MD DATE DO Physician Assistant Chiropractor Advanced Practice Nurse DRIVER S LICENSE NO. ADDRESS OF DRIVER MEDICAL CERTIFICATE EXPIRATION DATE DISTRIBUTION 1 COPY TO THE DRIVER 1 COPY TO THE MOTOR CARRIER STATE. 41-391. 49 and with knowledge of the driving duties I find this person is qualified and if applicable only when wearing corrective lenses driving within an exempt intracity zone 49 CFR 391. 62 wearing hearing aid accompanied by a waiver/exemption qualified by operation of 49 CFR 391. 64 The information I have provided regarding this physical examination is true and complete. 62 wearing hearing aid accompanied by a waiver/exemption qualified by operation of 49 CFR 391. 64 The information I have provided regarding this physical examination is true and complete. A complete examination form with any attachment embodies my findings completely and correctly and is on file in my office. A complete examination form with any attachment embodies my findings completely and correctly and is on file in my office. SIGNATURE OF MEDICAL EXAMINER TELEPHONE MD DATE DO Physician Assistant Chiropractor Advanced Practice Nurse DRIVER S LICENSE NO. 41-391. 49 and with knowledge of the driving duties I find this person is qualified and if applicable only when wearing corrective lenses driving within an exempt intracity zone 49 CFR 391. 62 wearing hearing aid accompanied by a waiver/exemption qualified by operation of 49 CFR 391. 64 The information I have provided regarding this physical examination is true and complete. A complete examination form with any attachment embodies my findings completely and correctly and is on file in my office. 62 wearing hearing aid accompanied by a waiver/exemption qualified by operation of 49 CFR 391. 64 The information I have provided regarding this physical examination is true and complete. A complete examination form with any attachment embodies my findings completely and correctly and is on file in my office. SIGNATURE OF MEDICAL EXAMINER TELEPHONE MD DATE DO Physician Assistant Chiropractor Advanced Practice Nurse DRIVER S LICENSE NO.

St 119 1 2009 form If you have questions about special accommodations call the information center. ST-119. 1 1/09 back General information This form is not valid unless all entries have been completed. If the organization does not have Form ST-119 Exempt Organization Certificate issued by the Tax Department purchases. New York State Department of Taxation and Finance ST-119. 1 New York State and Local Sales and Use Tax 1/09 Exempt Organization Exempt Purchase Certificate D Single D Blanket issued by the New York State Tax Department Your exempt organization number is not your federal employer identification see instructions. I certify that the organization named above holds a valid Form ST-119 Exempt Organization Certificate and is exempt from New York State and local sales and use taxes on its purchases. I also certify that the above statements are true and correct. I make these statements with the knowledge that knowingly making a false or fraudulent statement on this document is a misdemeanor under section 1817 of the New York State Tax Law and section 210. 45 of the Penal Law punishable by imprisonment for up to a year and a fine of up to 10 000 for an individual or 20 000 for a corporation. I understand that the Tax Department is authorized to investigate the validity of the exemption claimed or the accuracy of any information entered on this form. Print or type name of officer of organization Title Signature of officer of organization Date issued Need help h 1 nlemet acoess www. purchase certificate Name orsellei. Street address I EX Name of exempt organization/purchaser certificate City --------- ------ ------------------. Representatives Carefully of governmental - -. --- -. The exempt organization must be the direct purchaser You may not use this form to purchase ZIP code State and payer of record. --. motor fuel or diesel motor fuel exempt from tax. agencies or diplomatic missions may not use this form* read the instructions and other information on the back of this document. I certify that the organization named above holds a valid Form ST-119 Exempt Organization Certificate and is exempt from New York State and local sales and use taxes on its purchases. I also certify that the above statements are true and correct. I make these statements with the knowledge that knowingly making a false or fraudulent statement on this document is a misdemeanor under section 1817 of the New York State Tax Law and section 210. 45 of the Penal Law punishable by imprisonment for up to a year and a fine of up to 10 000 for an individual or 20 000 for a corporation* I understand that the Tax Department is authorized to investigate the validity of the exemption claimed or the accuracy of any information entered on this form* Print or type name of officer of organization Title Signature of officer of organization Date issued Need help h 1 nlemet acoess www. nystax. go for information forms and publications Fax-on-demand forms Forms are available 24 hours a day 1 800748-3676 7 days a week.

01 339 form 2013 2019 SAVE A COPY 01-339 Rev.4-13/8 CLEAR SIDE Texas Sales and Use Tax Resale Certificate Name of purchaser firm or agency as shown on permit Phone Area code and number Address Street number P. 01-339 Back items described below or on the attached order or invoice from Purchaser claims this exemption for the following reason the provisions of the Tax Code and/or all applicable law. O. Box or Route number City State ZIP code Out-of-state retailer s registration number or Federal Taxpayers Registry RFC number for retailers based in Mexico Retailers based in Mexico must also provide a copy of their Mexico registration form to the seller. I the purchaser named above claim the right to make a non-taxable purchase for resale of the taxable items described below or on the attached order or invoice from Seller Street address Description of items to be purchased on the attached order or invoice The taxable items described above or on the attached order or invoice will be resold rented or leased by me within the geographical limits of the United States of America its territories and possessions or within the geographical limits of the United Mexican States in their present form or attached to other taxable items to be sold. I understand that if I make any use of the items other than retention demonstration or display while holding them for sale lease or rental I must pay sales tax on the items at the time of use based upon either the purchase price or the fair market rental value for the period of time used* are purchased for use rather than for the purpose of resale lease or rental and depending on the amount of tax evaded the offense may range from a Class C misdemeanor to a felony of the second degree. Purchaser Title Date This certificate should be furnished to the supplier. Do not send the completed certificate to the Comptroller of Public Accounts. will be used in a manner other than that expressed in this certificate and depending on the amount of tax evaded the offense may range from a Class C misdemeanor to a felony of the second degree. NOTE This certificate cannot be issued for the purchase lease or rental of a motor vehicle. THIS CERTIFICATE DOES NOT REQUIRE A NUMBER TO BE VALID. O. Box or Route number City State ZIP code Out-of-state retailer s registration number or Federal Taxpayers Registry RFC number for retailers based in Mexico Retailers based in Mexico must also provide a copy of their Mexico registration form to the seller. I the purchaser named above claim the right to make a non-taxable purchase for resale of the taxable items described below or on the attached order or invoice from Seller Street address Description of items to be purchased on the attached order or invoice The taxable items described above or on the attached order or invoice will be resold rented or leased by me within the geographical limits of the United States of America its territories and possessions or within the geographical limits of the United Mexican States in their present form or attached to other taxable items to be sold.

Ky resale certificate 2013 201... Important--Certificate not valid unless completed. RESALE CERTIFICATE Check Applicable Block Blanket Single Purchase Address I hereby certify that holds a valid Sales and Use Tax Permit, Account No.

St 120 2018 2019 form Limitations on use issue Form ST-120. 1 Contractor Exempt Purchase Certificate if the specified by the certificate or issue Form AU-297 Direct Payment Permit or pay sales tax at the time of purchase. ST-120 Department of Taxation and Finance New York State and Local Sales and Use Tax Resale Certificate Name of seller Name of purchaser Street address City State ZIP code Mark an X in the appropriate box Single-use certificate Temporary vendors must issue a single-use certificate. Date prepared Page 2 of 2 ST-120 6/18 Instructions New Effective June 1 2018 use box C in Part 1 to purchase TSB-M-18 1 S Summary of Sales and Use Tax Changes Enacted in the 2018-2019 Budget Bill. Sales and Use Tax Classifications of Capital Improvements and Repairs to Real Property. Form ST 120 Resale Certificate is a sales tax exemption certificate. Enter all the information requested on the front of this form. This certificate is only for use by a purchaser who A is registered as a New York State sales tax vendor and has a valid Certificate of Authority issued by the Tax Department and is making purchases of tangible personal property other than motor fuel or diesel motor fuel or services that will be resold or transferred to the purchaser s customers or B is not required to be registered with the New York State Tax Department is registered with another state the District of Columbia a province of Canada or other country or is located in a state province or country which does not require sellers to register for sales tax or VAT purposes and is purchasing items for resale that will be either 1 delivered by the seller to the purchaser s customer or to an unaffiliated fulfillment service provider located in New York State or 2 delivered to the purchaser in New York State but resold from a business located outside the state. Retention of exemption certificates - You must keep this certificate for at least three years after the due date of the return to which it relates or the date the return was filed if later. Need help Visit our website at www. tax. ny. gov get information and manage your taxes online check for new online services and features Telephone assistance Sales Tax Information Center 518-485-2889 To order forms and publications 518-457-5431 Text Telephone TTY or TDD equipment users Dial 7-1-1 for the New York Relay Service. 6/18 Blanket certificate To the purchaser You may not use this certificate to purchase items or services that are not for resale. If you purchase tangible personal property or services for resale but use or consume the tangible personal property or services yourself in New York State you must report and pay the unpaid tax directly to New York State. Any misuse of this certificate will result in tax liabilities and substantial penalty and interest. Purchaser information please type or print I am engaged in the business of and principally sell Contractors may not use this certificate to purchase materials and supplies. Part 1 To be completed by registered New York State sales tax vendors I certify that I am a New York State vendor including a hotel operator or a dues or admissions recipient show vendor or entertainment vendor.

Form ca certificate 2015 2019 Print and Reset Form Reset Form STATE OF CALIFORNIA FRANCHISE TAX BOARD PO BOX 942857 SACRAMENTO CA 94257-0511 Notice Date Application for Certificate of Revivor Corporation Entity Number FEIN SOS Number Before the California Franchise Tax Board In the matter of the application for certificate of revivor of Address I request relief from suspension or forfeiture for this entity. Any person having an interest in relief from suspension or forfeiture. Domestic entities can also have a majority of the surviving trustees or directors sign on their behalf. FTB 3557 BC REV 03-2015 355747071371. I previously submitted or I am enclosing all required payments returns or documents. Print Name Title Signature Date Daytime Phone Number Those who can sign this application on behalf of an entity domestic or foreign include Any stockholder creditor member general partner or officer.

Ohio tax exemption form 2015 2... STEC B Rev. 3/15 Reset Form tax. ohio. gov Sales and Use Tax Blanket Exemption Certi cate The purchaser hereby claims exception or exemption on all purchases of tangible personal property and selected services made under this certi cate from Vendor s name and certi es that the claim is based upon the purchaser s proposed use of the items or services the activity of the purchase or both as shown hereon Purchaser must state a valid reason for claiming exception or exemption. Purchaser s name Purchaser s type of business Street address City state ZIP code Signature Title Date signed Vendor s license number if any Vendors of motor vehicles titled watercraft and titled outboard motors may use this certi cate to purchase these items under the resale exception. Otherwise purchaser must comply with either rule 5703-9-10 or 5703-9-25 of the Administrative Code. This certi cate cannot be used by construction contractors to purchase material for incorporation into real property under an exempt construction contract. This certi cate cannot be used by construction contractors to purchase material for incorporation into real property under an exempt construction contract.

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