KETCHIKAN GATEWAY BOROUGH 
                                     1900 FIRST AVENUE, SUITE 118 
                                      KETCHIKAN, AK 99901 
                                         
               APPLICATION FOR RESALE CERTIFICATE 
                                       
SALES TAX EXEMPTION DECLARATION 

I, the undersigned,  a representative of the business named below, do  certify  that I will purchase services,  rentals or item of 
tangible personal property for resale in the regular course of business, not for personal use, whether to be sold in the same form 
as received or in some modified condition or form or after fabrication or use with other substances or item. 
 
I understand that misuse of a resale certificate is unlawful and subject to prosecution and fine. 
 
BUSINESS NAME:                                                                                    KGB REG NUMBER 

ADDRESS: _____________________________________________________________________________________________ 
 
CITY/STATE/ZIP: _______________________________________________________________________________________ 
 
____________________________________________________________________         DATE: ________________________ 
SIGNATURE OF BUSINESS REPRESENTATIVE                     
 
LIST BELOW THE ITEMS YOU WILL BE PURCHASING FOR RESALE: 
 
___________________________________________________________________________________________________________________________________________________________ 
 
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There is a $10.00 processing fee which must be submitted with this application. To maintain certificate, 
application must be renewed and $10.00 fee paid January of each year.  
 
                        FOR OFFICIAL USE ONLY 
RESALE NUMBER ASSIGNED:                 DATE CARD/CERTIFICATE SENT: 

BY: