EFTA00522153.pdf

New York State Department of Taxation and Finance New York State and Local Sales and Use Tax ST-120 (1:11) Resale Certificate Name of seller Name of purchaser OS C Tiii-ezioe s . LI-C Street address Street address O 75 Zek-77,71°,.. Attie, 45 , .09C City State ZIP code City State ZIP code Att.- )40,e4 Al y / OaPa Mark an X in the appropriate box: ❑ Single-use certificate Er Blanket certificate Temporary vendors must issue a single-use certificate. To the purchaser: You may not use this certificate to purchase items or services that are not for resale. If you purchase tangible personal property or services for resale, but use or consume the tangible personal property or services yourself in New York State, you must report and pay the unpaid tax directly to New York State. My misuse of this certificate will result in tax liabilities and substantial penalty and interest. Purchaser information - plQase type or print I am engaged in the business of Or..$01/ and principally sell Pest9A) S€eohe_s (Contractors may not use this certificate to purchase materials and supplies.) Part 1 —To be completed by registered New York State sales tax vendors I cortify that I am: iYJ a New York State vendor (including a hotel canamiticar-a-auagn-achnissions recipient), show vendor or entertainment vendor. My valid Certificate of Authority number is ❑ a New York State temporary vendor. My valid Certificate of Authority number is and expires on I am purchasing: [21A. Tangible personal property (other than motor fuel or diesel motor fuel) • for resale in its present form or for resale as a physical component part of tangible personal property; • for use in performing taxable services where the property will become a physical component part of the property upon which the services will be performed, or the property will actually be transferred to the purchaser of the taxable service in conjunction with the performance of the service; or El B. A service for resale, including the servicing of tangible personal property held for sale. Part 2 —To be completed by non-NewYork State purchasers I certify that I am not registered nor am I required to be registered as a New York State sales tax vendor. I am registered to collect sales tax or value added tax (VAT) in the following state/jurisdiction and have been issued the following registration number (If sales tax or VAT registration is not required and a registration number is not issued by your home jurisdiction. indicate the location of your business and write not applicable on the line requesting the registration number.) I am purchasing: ❑ C. Tangible personal property (other than motor fuel or diesel motor fuel) for resale, and it is being delivered directly by the seller to my customer or to an unaffiliated fulfillment services provider in New York State. ❑ D. Tangible personal property for resale that will be resold from a business located outside New York State. Certification: I certify that the above statements are true. complete, and correct, and that no material information has been omitted.l make these statements and issue this exemption certificate with the knowledge that this document provides evidence that state and local sales or use taxes do not apply to a transaction or transactions for which I tendered this document and that willfully issuing this document with the intent to evade any such tax may constitute a felony or other crime under New York State Law, punishable by a substantial fine and a possible jail sentence. I understand that this document is required to be filed with, and deivered to, the vendor as agent for the Tax Department for the purposes of Tax Law section 1838 and is deemed a document required to be filed with the Tax Department for the purpose of prosecution of offenses. I also understand that the Tax Department is authorized to investigate the validity of tax exclusions or exemptions claimed and the accuracy of any nformation entered on this document. name and litre of owner, partner, or authorized person of purchaser MI D 4/4^) /19Ampieft Signal of ownear, tner. o 2orized rson of purchaser Date prepared war Substantial penalties will result from misuse of this certificate. EFTA00522153  fitY72YarkStibi..DePlitinent of TikationfillitEFlitainait 2 g r. JSC INTERIORS, LLC C/O RICHARD KAHN, MANAGER 575 LEXINGTON AVE FL 4 V NEW YORK NY 10022-6146 New York State Department of Taxation and Finance Certificate of Authority Identification number VALIDATED 47-2294796 (Usu Ibis !lumbar on oil ',Mums mid corwspondonco) 12/4/2014 Dept of Tax and Finance JSC INTERIORS, LLC CIO RICHARD KAHN, MANAGER 575 LEXINGTON AVE FL 4 NEW YORK NY 10022-6146 is authorized to collect sales and use taxes under Articles 28 and 29 of the New York State Tax Law, Nontransferable This certificate must be prominently displayed at your place of business. Fraudulent or other improper use of this certificate will cause it to be revoked. The certificate may not be OhotOcopied or reproduced 4020109100098 1086 - 3390635 P0000053-01 DTF-17-A (11/14) EFTA00522154