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Number) TAX ID #74-1109631 Phone (Area code and number) (210) 434-6711 411 SW 24TH STREET City, State, ZIP code SAN ANTONIO, TEXAS 78207-4689 I, the purchaser named above, claim an exemption from payment of sales and use taxes (for the purchase of taxable items described below or on the attached order or invoice) from: Seller: City, State, ZIP code: Street address: Description of items to be purchased or on the attached order or invoice: Purchaser claims this exemption for the following.

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