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To ensure the quick processing of this form, please make sure ALL fields are complete and correct

Company Name or Organization: __________________________________________________

(Must match name on Newegg Account)

Address: _____________________________________________________________________

I hereby certify that I hold a valid seller's permit # or exempt # _________________________

In order for us to reference your account,Please provide one or both of the following:
          Sales order number (SO#):________________
                               Customer #:________________

The tangible personal property will be used for official government business or will be purchased for resale, or as an ingredient or component part(s) of a new product to be resold, leased, or rented in the normal course of my business.

  Government Agency ~ City, State or Federal
  Resellers ~ I further certify that if the property purchased with this certificate is used or consumed so as to make it subject to sales or use tax, I will pay the tax due directly to the appropriate taxing authority or inform the seller to add tax to the billing. This certificate shall be a part of each order that I may place with in the future, and is valid until cancelled by me in writing or revoked by the city or state.
  Other sales tax exempt organization

Do you wish to be tax exempt for all future orders?
No, I only want to be exempt for SO#___________

Description of property to be purchased:
Computer peripherals
Other, please specify _______________________

Date: ____________ 
Print Your Name: _______________________________________
Phone number: __________________________________________
Signature: _______________________________________________

*Resellers ~ Please attach a copy of Reseller's Permit when faxing this form.
*Sales Exempt ~ Please attach a copy of the Government Credit Card with the account numbers REDACTED (Whited Out), or other sales tax exempt document with this form.

Fax to: (626) 271- 9403

Misuse of this certificate by the seller, lessor, buyer, lessee, or their representative may be punishable by fine, imprisonment, or loss of the right to issue certificates in some cities or states.