EmailMe Form - Certificate of Resale

Choose Your Showroom:

Arlington Heights

Chicago

Denver

Seller: CAI Designs
Arlington Heights
3425 N. Ridge Avenue Suite D | Arlington Heights, IL 60004
PH: (847) 398-4785 | FX: (847) 253-1880 | ah@caidesigns.net

Chicago
222 Merchandise Mart Plaza Suite 1619 | Chicago, IL 60654
PH: (312) 755-9163 | FX: (312) 755-1746 | chicago@caidesigns.net

Denver
595 S. Broadway Suite 100 | Denver, CO 80209
PH: (303) 282-8100
FX: (303) 282-7997
denver@caidesigns.net

SECTION 1: CHECK ONE OF THE FOLLOWING

I am the identified purchaser, and I certify that all the purchases I make from this seller are for resale.

I am the identified purchaser, and I certify that the following percentage % of all the puchases that I make from this seller are for resale.

Percentage %

SECTION 2: ITEMS COVERED BY THIS CERTIFICATE

All items purchased

Limited to the following items:

Enter items (applicable with option2)

SECTION 3: BASIS FOR EXEMPTION CLAIM (check only one box)

The purchaser is registered with the IL Dept of Revenue (enter registration # below)

The purchaser is registered as a reseller with the IL Dept of Revenue (enter resale # below)

The purchaser is authorized to do business out-of-state and will resell and deliver property only to purchasers located outside the state of IL (enter state and resale # below)

Registration #, Resale # OR State and Resale based on above answer)

SECTION 4: CERTIFICATION
I declare, under penalty of perjury, that the information on this certificate is true, that I have consulted the statutes, administrative rules and other sources of law applicable to my exemption, and that I have exercised reasonable care in assuring that my claim of exemption is valid under Illinois law. In the event this claim is disallowed, I accept full responsibility for the payment of tax, penalty and any accrued interest, including, if necessary, reimbursement to the vendor, CAI Designs, for tax and accrued interest.
Business Name:

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone

### - ### - ####

Email

Web Site

Signature

Clear

Date

MM / DD / YYYY

Certificate of Registration

Please scan and attach your certificate of registration that displays your resale number and expiration.

Front of Business Card

Back of Business Card