Texas Sales and Use Tax Resale Certificate

01-339

(Rev. 4-13/8)

Texas Sales and Use Tax Resale Certificate

Name of purchaser, firm or agency as shown on permit

Please List All Business and Personal Names Ordering on This Purchasing Account

Phone (Area code and number)

Address (Street & number, P.O. Box or Route number)

City, State, ZIP code

Texas Sales and Use Tax Permit Number (must contain 11 digits)

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: Couronne Co. / Glassnow

Street address: 12617 Beltex Rd.

City, State, ZIP code: Manor, Texas 78653

If you have purchased from Couronne Company/Glassnow before check here:

Description of items to be purchased on the attached order or invoice:

Description of the type of business activity generally engaged in or type of items normally sold by the purchaser:

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.

I understand that it is a criminal offense to give a resale certificate to the seller for taxable items that I know, at the time of purchase, 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 (SIGN HERE)

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Date