17050
Evergreen Place
City of Industry, CA 91745
Tel: 877-246-8294 Fax: 626-810-8313
Request
for Tax Exempt
Dear
Customer,
Due to California Tax Regulations, verification of a tax exempt
permit is required. Please complete the form and fax it to (626)810-8313
as soon as possible. Please also provide a copy of your tax exempt
permit. Thank you.
Company
Information
Billing Address
Company
:_______________________________
Contact
Person: ___________________________
Phone
#:_________________________________
E-mail: __________________________________
Address
1: ____________________________
Address
2: ____________________________
City
:__________________________________
State:_______
Zip:_______________________
Tax
Exempt ID : ______________________________________________________________________________