Figure: 34 TAC §3.358(i)

State of Texas
Maquiladora Exemption Certificate
Limited Sales, Excise, and Use Tax

Purchaser's Name _________________________________________________________

Street Address ___________________________________________________________

City, State, Zip Code _______________________________________________________

Maquiladora export permit number _____________________________________________

The undersigned hereby claims exemption from the payment of state and local
taxes upon its purchases of taxable items for export to Mexico from:

Seller:  ___________________________________________________________________

Street Address:  ____________________________________________________________

City, State, Zip Code ________________________________________________________

This certificate will remain in effect until the seller is otherwise notified and
does not cover purchases of taxable items to be resold in the form in which they
are purchased.

The undersigned agrees to accrue and pay the tax to the Comptroller of Public
Accounts on any goods purchased under this certificate that are not exported to
Mexico prior to their use.

This certificate is not valid unless accompanied by a copy of the Maquiladora
Export Permit issued by the Comptroller of Public Accounts.

Authorized Signature:  ________________________________________________________

Typed or printed name of person signing certificate:   __________________________________

Date:  _______________________