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For the purpose of proof of exemption, in transactions other than those in which the proof is set by standard documentation as detailed in Regulations 8A-350.1 and 8A-360.1, the minimum acceptable proof and documentation for each transaction shall be the completion, at the time of the transaction, in all material respects, of a certificate containing all the information set forth below. For the purpose of validating the vendor’s claim of exemption, such certificate is sufficient if executed by any person with apparent authority to act for the customer, and the information provided validates the claim.

INVALID UNLESS COMPLETED IN FULL

VENDOR’S NAME

Sales Invoice No.

Customer’s Exemption Claim

Town of Oro Valley Privilege License (Sales) Tax

Customer’s Business Name:

Customer’s Business Address:

Specific Business Activity:

(e.g., if retailer, lessor, or manufacturer, specify items leased, sold or made, i.e., cars, computers, clothes, etc.)

Customer’s License Nos.

Town:

State:

ITEMS CLAIMED AS EXEMPT FROM TAX

: All Items on This Invoice or Purchase Order.

or

: Only Those Items Marked with an “E”.

REASON FOR CLAIMED EXEMPTION:

: The items claimed as exempt are sold, rented, leased, or licensed by the above named customer in the normal course of its business activity.

or

: The items claimed as exempt are exempt from the Town of Oro Valley Privilege Tax for the following specific reason(s):

CUSTOMER’S CERTIFICATE

I certify that the above information is accurate to the best of my information and belief, and that I am authorized by the Customer above to acquire the items claimed as exempt on a tax-free basis on its behalf. I further understand that the making of a false or fraudulent claim to obtain a tax exemption is a Class One Misdemeanor under Town Code Section 8A-580.

______________________________________       ______________________________________

Name

Date

Title

((O)08-08, 04/16/2008)