RE: Sales Tax Questionnaire

113142000 - AGNESIAN HEALTHCARE INC

Historically, Amcon has NOT charged sales tax to our customers outside of the state of MO. In anticipation of some economic nexus laws that may have an impact for us in your state, we want to make sure that our records are accurately updated. Please complete the information requested below and then click on Submit. Please be sure to include your name and contact information in case we have any questions.

QUESTION		IF YES . . .
*(1) IS YOUR BUSINESS EXEMPT FROM SALES TAX? For reasons such as government, religious, non-profit?		Please attach a copy of your completed exemption form
* (2) DO YOU RESELL THE PRODUCTS PURCHASED FROM AMCON?		Please attach a copy of your completed resale form for Amcon
(3) DID YOU PAY USE TAX ON THE PRODUCTS PURCHASED FROM AMCON?*		No additional forms are needed at this time

**Most states require that purchasers pay use tax to their state for out-of-state purchases of taxable items if they were for internal use in the business and not resold.


*Name of Person Completing Form	*Email	*Phone #

Additional Comments
* must be filled out to submit the page.

We appreciate your prompt response. If you have any questions, feel free to reach out to us at salestax@amconlabs.com or contact your Amcon sales representative.