Type of exempt entity (please select one)*
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Tax Exempt Organization Name (As Listed on Certificate) *
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Doing Business As/Registered Fictious/Organization or School Name:
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Address of exempt entity *
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City *
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State *
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zip code *
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Certificate Number as shown on the Florida Consumer's Certificate of Exemption: *
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Tax Exempt Certificate Effective Date (Select Date) *
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Tax Exempt Certificate Expiration Date (Select Date) *
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(For Internal Use Only)
For Group Sales, please enter Order Number.
For Front Gate, please enter the Receipt NODE and TRANS NO (#### : ######)
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I, the undersigned, am a representative of the exempt entity identified below. The purchase of tangible personal property or services made on
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(EVENT / FIRST DATE OF VISIT) *
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from Universal City Development Partners is for use by the exempt entity identified below. The charges for the purchase of tangible personal property or services from the dealer identified above will be billed to and paid directly by the exempt entity. |
You can only pay with one form of payment. |
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If paying by check:
enter 0’s for last 4 of credit card and expiration date. |
Last four digits of the credit card number
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Expiration Date of the Credit Card (MM-YY))
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THIS CERTIFICATE MAY NOT BE USED TO MAKE PURCHASES OF TANGIBLE PERSONAL PROPERTY OR SERVICES FOR THE PERSONAL USE OF ANY INDIVIDUAL REPRESENTING THE EXEMPT ENTITY IDENTIFIED ABOVE. MUST BE FOR OFFICIAL CAPACITY ONLY. (RULE 12A-1.038, F.A.C.) |
Further, I understand that when a payment is made with any personal funds, then the purchase is subject to tax, even if I am to be reimbursed with the exempt entity’s funds. I understand that in order for this purchase to be tax exempt, then payment must be made directly from the funds of the exempt entity. Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true. |
Electronic Signature Consent * |
By checking this box and electronically signing below, I consent to use electronic records and signatures for this form, confirm that I am authorized to sign on behalf of the exempt entity identified above, and intend my electronic signature to have the same legal effect as my handwritten signature. |