This form contains 30 fields organized into 12 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Buyer Business Activity / Normally Sold Items Description
Business activity lines Text
Descripción del tipo de actividad comercial que tiene generalmente o el tipo de artículos normalmente vendido por el comprador Text
Buyer Information (Name, Address, Phone, City/State/ZIP)
Buyer name Text
Enter the buyer's full legal name, business name, or agency name as it should appear on the certificate.
Buyer street address Text
Enter the buyer's mailing street address, P.O. box, or route number (street name and number or postal box).
Buyer telephone Text
Enter the buyer's telephone number including area code.
Buyer city, state, ZIP Text
Enter the buyer's city, two-letter state abbreviation, and ZIP or postal code on a single line.
Buyer Information (Name, Phone, Address)
Buyer name (as on permit) Text
Enter the buyer's full name, firm, or agency name exactly as it appears on the permit.
Buyer telephone (area code and number) Text
Enter the buyer's telephone number including the area code.
Buyer address (street, P.O. box or route) Text
Enter the buyer's mailing street address, P.O. box, or route number as shown on the permit.
Buyer city, state and ZIP code Text
Enter the buyer's city, two-letter state abbreviation, and ZIP/postal code.
Buyer Tax/Resale Registration Numbers
Número de permiso para impuesto sobre ventas y uso (11 dígitos) Text
Introduzca el número de permiso del comprador para el impuesto sobre ventas y uso de Texas, usando exactamente 11 dígitos sin espacios ni guiones.
Max length: 11 characters
Número de registro de minorista de otro estado o RFC (México) Text
Introduzca el número de registro de minorista emitido por otro estado o el Registro Federal de Causantes (RFC) para minoristas basados en México, tal como aparece en su permiso o registro.
Description of Items Purchased
Exempt item description lines Text
Descripción de los artículos que se van a comprar o que están en la orden o factura adjunta Text
General
Borrar información en el lado del certificado de reventa Button
Borrar información en el lado del certificado de exención Button
Items to be Purchased Description
Items description lines Text
Descripción en la orden o factura adjunta de los artículos que se van a comprar Text
Reason for Exemption
Exemption reason lines Text
El comprador reclama esta exención por la siguiente razón Text
Seller/Vendor Information
Vendor name Text
Enter the full name of the seller or vendor as shown on their permit or legal documents.
Vendor street address Text
Enter the seller's street address, mailing address or P.O. box (Calle y número, Apartado postal o Número de ruta).
Vendor city, state, ZIP Text
Enter the seller's city, state and postal code for the address provided above.
Seller/Vendor Information (Name and Address)
Vendor / Seller Name Text
Enter the full name of the vendor or seller from whom the taxable items will be purchased.
Vendor Street Address Text
Enter the vendor's street address, P.O. box, or route number for the vendor's location.
Vendor City, State, ZIP Text
Enter the vendor's city, state (abbreviation), and postal code for the vendor's address.
Signature Details (Title and Date)
Title (Signer) Text
Enter the signer's job title, role, or capacity (for example: Owner, Manager, Authorized Representative) as it should appear with the signature.
Signature Date Date
Enter the date when the signer signed this certificate.
Signer Title and Date
Signer Title Text
Enter the signer's job title, role, or capacity (for example: Owner, Manager, Authorized Agent) as it should appear on the certificate.
Signer Date Date
Enter the date when the signer signed and dated this certificate.