Case File
efta-efta00522153DOJ Data Set 9OtherNew York State Department of Taxation and Finance
Date
Unknown
Source
DOJ Data Set 9
Reference
efta-efta00522153
Pages
2
Persons
0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
New York State Department of Taxation and Finance
New York State and Local Sales and Use Tax
Resale Certificate
ST-120
(1:11)
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 Att.- )40,e4
State
Al y
ZIP code
/ OaPa
Mark an X in the appropriate box:
K
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
K
a New York State temporary vendor. My valid Certificate of Authority number is
and expires on
I am purchasing:
[21 A. 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:
K
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.
K
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.
MI
D
4/4^) /19Ampieft
Signal
of ownear,
o
tner.
2orized
rson of purchaser
name and litre of owner, partner, or authorized person of purchaser
war
Date prepared
Substantial penalties will result from misuse of this certificate.
EFTA00522153
2
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fitY72YarkStibi..DePlitinent of
TikationfillitEFlitainait
JSC INTERIORS, LLC
C/O RICHARD KAHN, MANAGER
575 LEXINGTON AVE FL 4
NEW YORK NY 10022-6146
New York State Department of Taxation and Finance
Certificate of Authority
Identification number
47-2294796
(Usu Ibis !lumbar on oil ',Mums mid corwspondonco)
JSC INTERIORS, LLC
CIO RICHARD KAHN, MANAGER
575 LEXINGTON AVE FL 4
NEW YORK NY 10022-6146
VALIDATED
12/4/2014
Dept of Tax
and Finance
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
Technical Artifacts (3)
View in Artifacts BrowserEmail addresses, URLs, phone numbers, and other technical indicators extracted from this document.
Phone
2294796Phone
3390635Phone
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DOJ Data Set 9OtherUnknown
From: "Jeffrey E." <jeevacation@gmail.com>
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