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Resale Certificate Request Form

To obtain a Resale Certificate with copies of required documents, please complete the following information. The cost is $375.

Property Address Line 1:

Property Address Line 2:

Property City:

Property State:

Property Zip:

Tentative Closing Date:

Company Name:

Nature of Business:

Contact Person:

Address Line 1:

Address Line 2:

City:

State:

Zip:

Phone Number:

Fax Number:

Email Address:

Web Site Address (if any):