State of Ohio Tax Exemption Certificate
All Boxes need filled out or tax exemption will be denied
Purchaser must state a valid reason for claiming exception or exemption*
Common answers are Farm, Resale, PUCO, Manufacturing, Government, Church
Purchaser’s name*
Name of business requesting tax exemption
Purchaser’s type of business*
Choose One
Sole Proprietorship
Partnership
Limited Liability Company (LLC)
Corporation - C Corp
Corporation - S Corp
Corporation - B Corp
Corporation - Nonprofit
Government
Select from the following
Street address*
City, State, Zip code*
Title*
Title of Signatory
Signature*
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Type
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Choose your signature image
Date signed*
-
-
Today's date is prefilled
Vendor’s license number, if any
Enter your PUCO # or Venders # or type the word Farm, Government, Manufacturing or Church
Account number
Type in your Napa Account number. If unknown leave blank
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