Customer Form - SGW Greensboro

The following information must be completed in full before any sales transaction can be made. Please read and fill in all information carefully.

Full Name*

Business Name*

Please select your SGW sales representative.*

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Rep Email

DBA

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Geocoder

Address*

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

State*

Year Established

Phone*

Cell

Type of Business

Email*

Website

Do You Hold A Valid Resale Permit #?*

Yes, I hold a valid Resale Permit #

No, I do not hold a valid Resale Permit #

If Yes, Provide Number

Business Entity Type*

Corporate Tax ID #

Sign up for the SGW Newsletter

Yes! Sign me up for the SGW Newsletter

California Resale Certificate

2. I am engaged in the business of selling the following types of tangible personal property:

List all types of property being sold above.

3. I certify that this certificate is for the purchase from _______________ of the item(s) listed in Section 5 below.*

Please confirm.*

I will resell the item(s) listed in paragraph 5, which I am purchasing under this resale certificate in the form of tangible personal property in the regular course of my business operations, and I will do so prior to making any use of the item(s) other than demonstration and display while holding the item(s) for sale in the regular course of my business. I understand that if I use the item(s) purchased under this certificate in any manner other than as just described, I will owe use tax based on each item's purchase price or as otherwise provided by law.

5. Description of property to be purchased for resale:*

List all property to be purchased above.

Check to confirm.*

I have read and understand the following:

For Your Information: A person may be guilty of a misdemeanor under Revenue and Taxation Code section 6094.5 if the purchaser knows at the time of purchase that he or she will not resell the purchased item prior to any use (other than retention, demonstration, or display while holding it for resale) and he or she furnishes a resale certificate to avoid payment to the seller of an amount as tax. Additionally, a person misusing a resale certificate for personal gain or to evade the payment of tax is liable, for each purchase, for the tax that would have been due, plus a penalty of 10 percent of the tax or $500, whichever is greater.

I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.*

By checking this box and typing my name below, I am electronically signing my application.

Name of Purchaser*

Title*

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Address of Purchaser*

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

Phone*

Date*

Texas Sales and Use Tax Resale Certificate

Name of Purchaser*

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Geocoder

Address of Purchaser*

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

Phone*

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:*

Enter name of Seller above.

Optional: Attach order or invoice.

Accepted file types: jpg, gif, png, pdf, Max. file size: 5 MB.

PDF or image files only.

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Geocoder

Seller Address*

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

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

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

By checking the box below, I understand and agree with the following:*

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 the other items to be sold.

I understand that if I make any use of the items other than retention, demonstration, or display while holding 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 purcase, 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.

I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.*
By checking this box and typing my name below, I am electronically signing my application.

Name of Purchaser*

Title*

Date*
MM slash DD slash YYYY

Name
This field is for validation purposes and should be left unchanged.

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The following information must be completed in full before any sales transaction can be made. Please read and fill in all information carefully.

California Resale Certificate

Texas Sales and Use Tax Resale Certificate

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