Firm Name/Company:___________________________________________________________________
Address of Purchaser: _________________________________________________________________
I HEREBY CERTIFY: That I hold valid seller's permit No.#_____________________________________
Issued pursuant to the Sales and Use Tax Law; that I am engaged in the business of selling:

Computer Peripherals & Accessories

that the tangible personal property described herein which I shall purchase from:

Multiwave/CLT Computers Inc.

will be resold by me in the form of tangible personal property;provided, however, that in the event any of such property is used for any purpose other than retention, demonstration, or display while holding it for sale in the regular course of business, it is understood that I am required by Sales and Use Tax Law to report and pay tax, measured by the purchase price of such property or other authorized amount. Description of property to be purchased:

COMPUTER PARTS                              

Date:________________ 20____    Printed Name of Purchaser: ________________________________

Phone: (___)____________________ By and Title: __________________________
                                                            (Signature of Purchaser or Auth. Agent)