SALEST~1 - District 14-D Lions
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
[pic]
BUREAU OF BUSINESS TRUST FUND TAXES
DEPT. 280909
HARRISBURG, PA 17128-0909
SALES TAX
CERTIFICATE OF EXEMPTION
Entity ID: 23-6296767/001
Notice Number 810-991-511-021-1
Notice Date: February 16, 2011
Account Number: 75-384-600
Exemption Type: CHARITABLE
Void After: February 29, 2016
PENNSYLVANIA LIONS MULTI. DIST. 14
949 EAST PARK DR.
HARRISBURG, PA 17111-2810
USE OF THIS CERTIFICATE FOR PERSONAL OR NONEXEMPT PURCHASES WILL RESULT IN CANCELLATION OF EXEMPT STATUS
Always refer to your Account Number in correspondence.
It your organization changes its name, address or ceases operation, complete the appropriate sections below and return this form to: PA Department of Revenue, Bureau of Business Trust Fund Taxes, Exemption Unit, Dept. 280909, Harrisburg, PA 17128-0909. Any questions may be addressed to the above address, or call (717) 783-5473; TT # Only 1-800-447-3020 (Service for Taxpayers With Special Hearing and/or Speaking Needs).
|Name and/for Address Change |Cancellation of Exemption |
| | |
| | |
|Name | |
| | |
| | |
| | |
|Address | |
| |Date organization |
| |ceased operation |
| | |
| | |
|City State Zip Code | |
| | |
| | |
| | |
|Signature and Title of Authorized Representative | |Date |
| | | |
| | | |
|Print Name | | |
| | | |
| | | |
|Telephone No. ( ) | | |
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.