Sales Tax Exemption Certificate Owner Name: Email: Phone: Cell Phone: Address: City: States Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Contractor Name: Email: Phone: Cell Phone: Project Address: City: States Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Project Description: Estimated Value: Authorization By Town Authorized Signature Town of De Beque: Good For 180 Days Through: This certificate is to serve as proof that the above owner/contractor has a construction project in the Town of De Beque, Colorado, and has paid a 2% use tax to the Town. For verification please contact Shirley Nichols, Town Clerk, or Diane Rickstrew, Deputy Clerk, 970-283-5475 x 101. Note to Supplier: Keep this form for your records Need assistance with this form?
