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DAVIT PLEASE RETAIN A COPY FOR FUTURE AUDIT Name of Purchaser Purchaser s Sales Tax Number (if Purchaser does not have a Sales Tax Number, provide Federal Employer Identification Number or Social Security Number) Name of Dealer Dealer s Sales Tax Number (if known) Dealer s Street Address City State Date of Purchase 1. Invoice No. Gross Amount of Sale Excluding Tax Did you request a sales tax refund from the Dealer? Exempt Portion of Sale Yes Zip Code Tax Paid by Purchaser to.

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