Hillside Tax Exempt Form

For use by tax-exempt organizations purchasing from Hillside Gardens

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Email *
1. Purchaser Information : 
Legal Organization Name: (As registered with the IRS)
 *
Contact Person Name: *
Phone Number: *
Email Address: *
Billing Address: *
Information Tax-Exempt Number / EIN:
 *
State of Issuance: *
Expiration Date (if applicable): *
Tax-Exempt Certificate: A completed and signed Colorado Affidavit of Exempt Sale (Form DR 5002) or a valid exemption certificate issued by the Colorado Department of Revenue. *
Required
Today's Date *
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Certification Statement

"I certify that the above organization is a tax-exempt entity and that the purchases made under this exemption will be used for tax-exempt purposes only. I understand that misuse of tax-exempt status may result in penalties and revocation of exemption."

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