Figure: 34 TAC §3.289(g)

Alcoholic Beverage Exemption Certificate

I, the undersigned, hereby claim an exemption from payment of taxes under the Tax Code, sec. 151.308(8), (9), for the purchase of the taxable items described below or on attached order or invoice to be purchased from _________________________________________

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I claim this exemption because I hold _____________________(type of permit)_____________________________________________

_______________________________, _________________(number of permit)___________________________________________

issued by the Texas Alcoholic Beverage Commission. I understand that I will be liable for payment of the limited sales and use tax if I use the items covered by this certificate in any manner or for any reason other than in a sale which is subject to the gross receipts tax as levied under Texas Tax Code, Chapter 183.

Executed this ___________ day of ____________________, 20___.

Purchaser ___________________________________________________

Business Address ___________________________________________________

Address ___________________________________________________

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