Title 26: Internal Revenue
PART 52—ENVIRONMENTAL TAXES
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§ 52.4682-2 Qualifying sales.
(a) In general—(1) Special rules applicable to certain sales. Special rules apply to sales of ODCs in the following cases:
(i) Under section 4682(d)(2), §52.4682–1(c), and §52.4682–4(b)(2)(v) (relating to ODCs used as a feedstock), ODCs sold in qualifying sales are not taxed.
(ii) Under section 4682(g), §52.4682–1(d), and §52.4682–4(d)(2) (relating to ODCs used in the manufacture of rigid foam insulation), ODCs sold in qualifying sales are not taxed in 1990 and are taxed at a reduced rate in 1991, 1992, and 1993.
(iii) Under section 4682(g)(4) and §52.4682–1(g) (relating to ODCs used as medical sterilants), ODCs sold in qualifying sales are taxed at a reduced rate in 1993.
(iv) Under section 4682(g)(4) and §52.4682–1(h) (relating to ODCs used as propellants in metered-dose inhalers), ODCs sold in qualifying sales are taxed at a reduced rate in years after 1992.
(2) Qualifying sales. A sale of ODCs is not a qualifying sale unless the requirements of this section are satisfied. Although registration with the Internal Revenue Service is not required to establish that a sale of ODCs is a qualifying sale, the certificates required by this section shall be made available for inspection by internal revenue agents and officers.
(b) Requirements for qualification—(1) Use as a feedstock. A sale of ODCs is a qualifying sale for purposes of §§52.4682–1(c) and 52.4682–4(b)(2)(v) if the manufacturer or importer of the ODCs—
(i) Obtains a certificate in substantially the form set forth in paragraph (d)(2) of this section from the purchaser of the ODCs; and
(ii) Relies on the certificate in good faith.
(2) Use in the manufacture of rigid foam insulation. A sale of ODCs is a qualifying sale for purposes of §§52.4682–1(d) and 52.4682–4(d)(2) if the manufacturer or importer of the ODCs—
(i) Obtains a certificate in substantially the form set forth in paragraph (d)(3) of this section from the purchaser of the ODCs; and
(ii) Relies on the certificate in good faith.
(3) Use as medical sterilants. A sale of ODCs is a qualifying sale for purposes of §52.4682–1(g) if the manufacturer or importer of the ODCs—
(i) Obtains a certificate in substantially the form set forth in paragraph (d)(4) of this section from the purchaser of the ODCs; and
(ii) Relies on the certificate in good faith.
(4) Use as propellants in metered-dose inhalers. A sale of ODCs is a qualifying sale for purposes of §§52.4682–1(h) and 52.4682–4(b)(2)(vii) if the manufacturer or importer of the ODCs—
(i) Obtains a certificate in substantially the form set forth in paragraph (d)(5) of this section from the purchaser of the ODCs; and
(ii) Relies on the certificate in good faith.
(c) Good faith reliance—(1) In general. The requirements of paragraph (b) of this section are not satisfied with respect to a sale of ODCs and the sale is not a qualifying sale if at the time of the sale—
(i) The manufacturer or importer has reason to believe that the purchaser will use the ODCs other than for the purpose set forth in the certificate; or
(ii) The Internal Revenue Service has notified the manufacturer or importer that the purchaser's right to provide a certificate has been withdrawn.
(2) Withdrawal of right to provide a certificate. The Internal Revenue Service may withdraw the right of a purchaser to provide a certificate to its supplier if such purchaser uses the ODCs to which its certificate applies other than for the purpose set forth in such certificate, or otherwise fails to comply with the terms of the certificate. The Internal Revenue Service may notify the supplier to whom the purchaser provided the certificate that the purchaser's right to provide a certificate has been withdrawn.
(d) Certificate—(1) In general—(i) Rules relating to all certificates. This paragraph (d) sets forth certificates that satisfy the requirements of paragraphs (b)(1) through (4) of this section. The certificate shall consist of a statement executed and signed under penalties of perjury by a person with authority to bind the purchaser. A certificate provided under paragraph (d)(2) or (5) of this section may apply to a single purchase or to multiple purchases and need not specify an expiration date. A certificate provided under paragraph (d)(3) or (4) of this section may apply to a single purchase or multiple purchases, and will expire as of December 31, 1993, unless an earlier expiration date is specified in the certificate. A new certificate must be given to the supplier if any information on the current certificate changes. The certificate may be included as part of any business records normally used to document a sale.
(ii) Special rule relating to certificates executed before January 1, 1992. Certificates provided under this paragraph (d)(2) and executed before January 1, 1992, satisfy the requirements of paragraph (b) of this section if they are in substantially the same form as certificates set forth in §52.4682–2T.
(2) Certificate relating to ODCs used as a feedstock—(i) ODCs that will be resold for use by the second purchaser as a feedstock. If the purchaser will resell the ODCs to a second purchaser for use by such second purchaser as a feedstock, the certificate provided by the purchaser must be in substantially the following form:
Certificate of Purchaser of Chemicals That Will Be Resold for Use by the Second Purchaser as a Feedstock
(To support tax-free sales under section 4682(d)(2) of the Internal Revenue Code.)
Date____________________
The undersigned purchaser (“Purchaser”) hereby certifies the following under penalties of perjury:
The following percentage of ozone-depleting chemicals purchased from
____________________
(name and address of seller)
will be resold by Purchaser to persons (Second Purchasers) that certify to Purchaser that they are purchasing the ozone-depleting chemicals for use as a feedstock (as defined in §52.4682–1(c)(3) of the Environmental Tax Regulations).
------------------------------------------------------------------------ Product Percentage------------------------------------------------------------------------CFC-11.....................................CFC-12.....................................CFC-113....................................CFC-114....................................CFC-115....................................Carbon tetrachloride.......................Methyl chloroform..........................Other (specify)............................------------------------------------------------------------------------
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This certificate applies to (check and complete as applicable):
___ All shipments to Purchaser at the following location(s): ____________________
____________________
____________________
___ All shipments to Purchaser under the following Purchaser account number(s): ____________________
____________________
____________________
___ All shipments to Purchaser under the following purchase order(s): ____________________
____________________
____________________
___ One or more shipments to Purchaser identified as follows: ____________________
____________________
____________________
Purchaser will not claim a credit or refund under section 4682(d)(2)(B) of the Internal Revenue Code for any ozone-depleting chemicals covered by this certificate.
Purchaser understands that any use by Purchaser of the ozone-depleting chemicals to which this certificate applies other than for the purpose set forth in this certificate may result in the withdrawal by the Internal Revenue Service of Purchaser's right to provide a certificate.
Purchaser will retain the business records needed to document the sales covered by this certificate and will make such records available for inspection by Government officers. Purchaser also will retain and make available for inspection by Government officers the certificates of its Second Purchasers.
Purchaser has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. In addition, the Internal Revenue Service has not notified Purchaser that the right to provide a certificate has been withdrawn from any Second Purchaser who will purchase ozone-depleting chemicals to which this certificate applies.
Purchaser understands that the fraudulent use of this certificate may subject Purchaser and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. ____________________
Signature ____________________
Printed or typed name of person signing ____________________
Title of person signing ____________________
Name of Purchaser ____________________
Address ____________________
____________________
Taxpayer Identifying Number
(ii) ODCs that will be used by the purchaser as a feedstock. If the purchaser will use the ODCs as a feedstock, the certificate provided by the purchaser must be in substantially the following form:
Certificate of Purchaser of Chemicals That Will Be Used by the Purchaser as a Feedstock
(To support tax-free sales under section 4682(d)(2) of the Internal Revenue Code.) Date____________________
The undersigned purchaser (“Purchaser”) hereby certifies the following under penalties of perjury:
The following percentage of ozone-depleting chemicals purchased from ____________________
(name and address of seller)
will be used by Purchaser as a feedstock (as defined in §52.4682–1(c)(3) of the Environmental Tax Regulations).
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------------------------------------------------------------------------ Kilograms to be Product Percentage transformed------------------------------------------------------------------------CFC-11...........................CFC-12...........................CFC-113..........................CFC-114..........................CFC-115..........................Carbon tetrachloride.............Methyl chloroform................Other (specify)..................------------------------------------------------------------------------
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This certificate applies to (check and complete as applicable):
___ All shipments to Purchaser at the following location(s): ____________________
____________________
____________________
___ All shipments to Purchaser under the following Purchaser account number(s): ____________________
____________________
____________________
___ All shipments to Purchaser under the following purchase order(s): ____________________
____________________
____________________
___ One or more shipments to Purchaser identified as follows: ____________________
____________________
____________________
Purchaser will not claim a credit or refund under section 4682(d)(2)(B) of the Internal Revenue Code for any ozone-depleting chemicals covered by this certificate.
Purchaser understands that any use of the ozone-depleting chemicals to which this certificate applies other than as a feedstock may result in the withdrawal by the Internal Revenue Service of Purchaser's right to provide a certificate.
Purchaser will retain the business records needed to document the use as a feedstock of the ozone-depleting chemicals to which this certificate applies and will make such records available for inspection by Government officers.
Purchaser has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn.
Purchaser understands that the fraudulent use of this certificate may subject Purchaser and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. ____________________
Signature ____________________
Printed or typed name of person signing ____________________
Title of person signing ____________________
Name of Purchaser ____________________
Address ____________________
____________________
Taxpayer Identifying Number
(3) Certificate relating to ODCs used in the manufacture of rigid foam insulation—(i) ODCs that will be resold to a second purchaser for use by the second purchaser in the manufacture of rigid foam insulation. If the purchaser will resell the ODCs to a second purchaser for use by such second purchaser in the manufacture of rigid foam insulation, the certificate provided by the purchaser must be in substantially the following form:
Certificate of Purchaser of Chemicals That Will Be Resold for Use by the Second Purchaser in the Manufacture of Rigid Foam Insulation
(To support tax-free or tax-reduced sales under section 4682(g) of the Internal Revenue Code.) Effective Date____________________
Expiration Date____________________
(not after 12/31/93)
The undersigned purchaser (“Purchaser”) hereby certifies the following under penalties of perjury:
The following percentage of ozone-depleting chemicals purchased from ____________________
(name and address of seller)
will be resold by Purchaser to persons (Second Purchasers) that certify to Purchaser that they are purchasing the ozone-depleting chemicals for use in the manufacture of rigid foam insulation (as defined in §52.4682–1(d)(3) and (4) of the Environmental Tax Regulations).
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------------------------------------------------------------------------ Product Percentage------------------------------------------------------------------------CFC-11.....................................CFC-12.....................................CFC-113....................................CFC-114....................................CFC-115....................................Carbon tetrachloride.......................Methyl chloroform..........................Other (specify)............................------------------------------------------------------------------------
|
This certificate applies to (check and complete as applicable):
___ All shipments to Purchaser at the following location(s): ____________________
____________________
____________________
___ All shipments to Purchaser under the following Purchaser account number(s): ____________________
____________________
____________________
___ All shipments to Purchaser under the following purchase order(s): ____________________
____________________
____________________
___ One or more shipments to Purchaser identified as follows: ____________________
____________________
____________________
Purchaser will not claim a credit or refund under section 4682(g)(3) of the Internal Revenue Code for any ozone-depleting chemicals covered by this certificate.
Purchaser understands that any use by Purchaser of the ozone-depleting chemicals to which this certificate applies other than for the purpose set forth in this certificate may result in the withdrawal by the Internal Revenue Service of Purchaser's right to provide a certificate.
Purchaser will retain the business records needed to document the sales covered by this certificate and will make such records available for inspection by Government officers. Purchaser also will retain and make available for inspection by Government officers the certificates of its Second Purchasers.
Purchaser has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. In addition, the Internal Revenue Service has not notified Purchaser that the right to provide a certificate has been withdrawn from any Second Purchaser who will purchase ozone-depleting chemicals to which this certificate applies.
Purchaser understands that the fraudulent use of this certificate may subject Purchaser and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. ____________________
Signature ____________________
Printed or typed name of person signing ____________________
Title of person signing ____________________
Name of Purchaser ____________________
Address ____________________
____________________
Taxpayer Identifying Number
(ii) ODCs that will be used by the purchaser in the manufacture of rigid foam insulation. If the purchaser will use the ODCs in the manufacture of rigid foam insulation, the certificate provided by the purchaser must be in substantially the following form:
Certificate of Purchaser of Chemicals That Will Be Used by the Purchaser in the Manufacture of Rigid Foam Insulation
(To support tax-free or tax-reduced sales under section 4682(g) of the Internal Revenue Code.) Effective Date____________________
Expiration Date____________________
(not after 12/31/93)
The undersigned purchaser (“Purchaser”) hereby certifies the following under penalties of perjury:
The following percentage of ozone-depleting chemicals purchased from ____________________
(name and address of seller)
will be used by Purchaser in the manufacture of rigid foam insulation (as defined in §52.4682–1(d) (3) and (4) of the Environmental Tax Regulations).
|
------------------------------------------------------------------------ Product Percentage------------------------------------------------------------------------CFC-11.....................................CFC-12.....................................CFC-113....................................CFC-114....................................CFC-115....................................Carbon tetrachloride.......................Methyl chloroform..........................Other (specify)............................------------------------------------------------------------------------
|
This certificate applies to (check and complete as applicable):
___ All shipments to Purchaser at the following location(s): ____________________
____________________
____________________
___ All shipments to Purchaser under the following Purchaser account number(s): ____________________
____________________
____________________
___ All shipments to Purchaser under the following purchase order(s): ____________________
____________________
____________________
___ One or more shipments to Purchaser identified as follows: ____________________
____________________
____________________
Purchaser will not claim a credit or refund under section 4682(g)(3) of the Internal Revenue Code for any ozone-depleting chemicals covered by this certificate.
Purchaser understands that any use by Purchaser of the ozone-depleting chemicals to which this certificate applies other than in the manufacture of rigid foam insulation may result in the withdrawal by the Internal Revenue Service of Purchaser's right to provide a certificate.
Purchaser will retain the business records needed to document the use in the manufacture of rigid foam insulation of the ozone-depleting chemicals to which this certificate applies and will make such records available for inspection by Government officers.
Purchaser has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn.
Purchaser understands that the fraudulent use of this certificate may subject Purchaser and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. ____________________
Signature ____________________
Printed or typed name of person signing ____________________
Title of person signing ____________________
Name of Purchaser ____________________
Address ____________________
____________________
Taxpayer Identifying Number
(4) Certificate relating to ODCs used as medical sterilants—(i) ODCs that will be resold for use by the second purchaser as medical sterilants. If the purchaser will resell the ODCs to a second purchaser for use by such second purchaser as medical sterilants, the certificate provided by the purchaser must be in substantially the following form:
CERTIFICATE OF PURCHASER OF CHEMICALS THAT WILL BE RESOLD FOR USE BY THE SECOND PURCHASER AS MEDICAL STERILANTS
(To support tax-reduced sales under section 4682(g)(4) of the Internal Revenue Code.) Effective Date____________________
Expiration Date____________________
(not after 12/31/93)
The undersigned purchaser (Purchaser) certifies the following under penalties of perjury:
The following percentage of ozone-depleting chemicals purchased from: ____________________
(Name of seller) ____________________
(Address of seller)
will be resold by Purchaser to persons (Second Purchasers) that certify to Purchaser that they are purchasing the ozone-depleting chemicals for use as medical sterilants (as defined in §52.4682–1(g)(3) of the Environmental Tax Regulations).
|
------------------------------------------------------------------------ Product Percentage------------------------------------------------------------------------CFC-12..................................................... _____------------------------------------------------------------------------
|
This certificate applies to (check and complete as applicable):
___ All shipments to Purchaser at the following location(s): ____________________
____________________
____________________
___ All shipments to Purchaser under the following Purchaser account number(s): ____________________
____________________
____________________
___ All shipments to Purchaser under the following purchase order(s): ____________________
____________________
____________________
___ One or more shipments to Purchaser identified as follows: ____________________
____________________
____________________
Purchaser will not claim a credit or refund under section 4682(g)(4) of the Internal Revenue Code for any ozone-depleting chemicals covered by this certificate.
Purchaser understands that any use by Purchaser of the ozone-depleting chemicals to which this certificate applies other than for the purpose set forth in this certificate may result in the withdrawal by the Internal Revenue Service of Purchaser's right to provide a certificate.
Purchaser will retain the business records needed to document the sales covered by this certificate and will make such records available for inspection by Government officers. Purchaser also will retain and make available for inspection by Government officers the certificates of its Second Purchasers.
Purchaser has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. In addition, the Internal Revenue Service has not notified Purchaser that the right to provide a certificate has been withdrawn from any Second Purchaser who will purchase ozone-depleting chemicals to which this certificate applies.
Purchaser understands that the fraudulent use of this certificate may subject Purchaser and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. ____________________
Name of Purchaser ____________________
Address of Purchaser ____________________
____________________
Taxpayer Identifying Number of Purchaser ____________________
Title of person signing ____________________
Printed or typed name of person signing ____________________
Signature
(ii) ODCs that will be used by the purchaser as medical sterilants. If the purchaser will use the ODCs as medical sterilants, the certificate provided by the purchaser must be in substantially the following form:
CERTIFICATE OF PURCHASER OF CHEMICALS THAT WILL BE USED BY THE PURCHASER AS MEDICAL STERILANTS
(To support tax-reduced sales under section 4682(g)(4) of the Internal Revenue Code.) Effective Date____________________
Expiration Date____________________
(not after 12/31/93)
The undersigned purchaser (Purchaser) certifies the following under penalties of perjury:
The following percentage of ozone-depleting chemicals purchased from: ____________________
(Name of seller) ____________________
(Address of seller)
will be used by Purchaser as medical sterilants (as defined in §52.4682–1(g)(3) of the Environmental Tax Regulations).
|
------------------------------------------------------------------------ Product Percentage------------------------------------------------------------------------CFC-12..................................................... _____------------------------------------------------------------------------
|
This certificate applies to (check and complete as applicable):
___ All shipments to Purchaser at the following location(s): ____________________
____________________
____________________
___ All shipments to Purchaser under the following Purchaser account number(s): ____________________
____________________
____________________
___ All shipments to Purchaser under the following purchase order(s): ____________________
____________________
____________________
___ One or more shipments to Purchaser identified as follows: ____________________
____________________
____________________
Purchaser will not claim a credit or refund under section 4682(g)(4) of the Internal Revenue Code for any ozone-depleting chemicals covered by this certificate.
Purchaser understands that any use by Purchaser of the ozone-depleting chemicals to which this certificate applies other than as medical sterilants may result in the withdrawal by the Internal Revenue Service of Purchaser's right to provide a certificate.
Purchaser will retain the business records needed to document the use as medical sterilants of the ozone-depleting chemicals to which this certificate applies and will make such records available for inspection by Government officers.
Purchaser has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn.
Purchaser understands that the fraudulent use of this certificate may subject Purchaser and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. ____________________
Name of Purchaser ____________________
Address of Purchaser ____________________
____________________
Taxpayer Identifying Number of Purchaser ____________________
Title of person signing ____________________
Printed or typed name of person signing ____________________
Signature
(5) Certificate relating to ODCs used as propellants in metered-dose inhalers—(i) ODCs that will be resold for use by the second purchaser as propellants in metered-dose inhalers. If the purchaser will resell the ODCs to a second purchaser for use by such second purchaser as propellants in metered-dose inhalers, the certificate provided by the purchaser must be in substantially the following form:
CERTIFICATE OF PURCHASER OF CHEMICALS THAT WILL BE RESOLD FOR USE BY THE SECOND PURCHASER AS PROPELLANTS IN METERED-DOSE INHALERS
(To support tax-reduced sales under section 4682(g)(4) of the Internal Revenue Code.) Date____________________
The undersigned purchaser (Purchaser) certifies the following under penalties of perjury:
The following percentage of ozone-depleting chemicals purchased from: ____________________
(Name of seller) ____________________
(Address of seller)
will be resold by Purchaser to persons (Second Purchasers) that certify to Purchaser that they are purchasing the ozone-depleting chemicals for use as propellants in metered-dose inhalers (as defined in §52.4682–1(h)(3) of the Environmental Tax Regulations).
|
------------------------------------------------------------------------ Product Percentage------------------------------------------------------------------------CFC-11..................................................... ____CFC-12..................................................... ____CFC-114.................................................... ____------------------------------------------------------------------------
|
This certificate applies to (check and complete as applicable):
____ All shipments to Purchaser at the following location(s): ____________________
____________________
____________________
____ All shipments to Purchaser under the following Purchaser account number(s): ____________________
____________________
____________________
____ All shipments to Purchaser under the following purchase order(s): ____________________
____________________
____________________
____ One or more shipments to Purchaser identified as follows: ____________________
____________________
____________________
Purchaser will not claim a credit or refund under section 4682(g)(4) of the Internal Revenue Code for any ozone-depleting chemicals covered by this certificate.
Purchaser understands that any use by Purchaser of the ozone-depleting chemicals to which this certificate applies other than for the purpose set forth in this certificate may result in the withdrawal by the Internal Revenue Service of Purchaser's right to provide a certificate.
Purchaser will retain the business records needed to document the sales covered by this certificate and will make such records available for inspection by Government officers. Purchaser also will retain and make available for inspection by Government officers the certificates of its Second Purchasers.
Purchaser has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. In addition, the Internal Revenue Service has not notified Purchaser that the right to provide a certificate has been withdrawn from any Second Purchaser who will purchase ozone-depleting chemicals to which this certificate applies.
Purchaser understands that the fraudulent use of this certificate may subject Purchaser and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. ____________________
Name of Purchaser ____________________
Address of Purchaser ____________________
____________________
Taxpayer Identifying Number of Purchaser ____________________
Title of person signing ____________________
Printed or typed name of person signing ____________________
Signature
(ii) ODCs that will be used by the purchaser as propellants in metered-dose inhalers. If the purchaser will use the ODCs as propellants in metered-dose inhalers, the certificate provided by the purchaser must be in substantially the following form:
CERTIFICATE OF PURCHASER OF CHEMICALS THAT WILL BE USED BY THE PURCHASER AS PROPELLANTS IN METERED-DOSE INHALERS
(To support tax-reduced sales under section 4682(g)(4) of the Internal Revenue Code.) Date____________________
The undersigned purchaser (Purchaser) certifies the following under penalties of perjury:
The following percentage of ozone-depleting chemicals purchased from: ____________________
(Name of seller) ____________________
(Address of seller)
will be used by Purchaser as propellants in metered-dose inhalers (as defined in §52.4682–1(h)(3) of the Environmental Tax Regulations).
|
------------------------------------------------------------------------ Product Percentage------------------------------------------------------------------------CFC-11..................................................... ____CFC-12..................................................... ____CFC-114.................................................... ____------------------------------------------------------------------------
|
This certificate applies to (check and complete as applicable):
____ All shipments to Purchaser at the following location(s): ____________________
____________________
____________________
____ All shipments to Purchaser under the following Purchaser account number(s): ____________________
____________________
____________________
____ All shipments to Purchaser under the following purchase order(s): ____________________
____________________
____________________
____ One or more shipments to Purchaser identified as follows: ____________________
____________________
____________________
Purchaser will not claim a credit or refund under section 4682(g)(4) of the Internal Revenue Code for any ozone-depleting chemicals covered by this certificate.
Purchaser understands that any use by Purchaser of the ozone-depleting chemicals to which this certificate applies other than as propellants in metered-dose inhalers may result in the withdrawal by the Internal Revenue Service of Purchaser's right to provide a certificate.
Purchaser will retain the business records needed to document the use as propellants in metered-dose inhalers of the ozone-depleting chemicals to which this certificate applies and will make such records available for inspection by Government officers.
Purchaser has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn.
Purchaser understands that the fraudulent use of this certificate may subject Purchaser and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. ____________________
Name of Purchaser ____________________
Address of Purchaser ____________________
____________________
Taxpayer Identifying Number of Purchaser ____________________
Title of person signing ____________________
Printed or typed name of person signing ____________________
Signature
[T.D. 8370, 56 FR 56308, Nov. 4, 1991, as amended by T.D. 8622, 60 FR 52850, Oct. 11, 1995]
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