BLANKET CERTIFICATE OF EXEMPTION 
(Prescribed By The Tax Commission Of Ohio) 
The undersigned certifies that all material, merchandise, or goods purchased 1 from 
THE STORRS & HARRISON CO. 
after .... shall be purchased: 
[ ] For resale in the form of tangible personal property. 
[ ] To incorporate the thing transferred as a material or part into tangible per¬ 
sonal property for sale by manufacturing, assembling, processing, or refining. 
[ ] To use or consume the thing transferred directly in the production of tangible 
personal property for sale by manufacturing, processing, refining, mining, 
farming, horticulture, or floriculture. 
[ 3 To use or consume the thing transferred directly in making retail sales, the 
rendition of a public utility service, or industrial cleaning of tangible person¬ 
al property. 
[ 3 By the State of Ohio, or one of its political subdivisions. 
[ 3 In interstate commerce.* 
£ 3 By charitable and/or religious organization#. 
£ 3 By the Federal Government, or a governmental instrumentality. 
£ 3 .. 
Other—(specify in detail) 
This certificate shall be considered a part of each order which should be given to< the 
above named vendor, unless the order otherwise specifies. Thisi certificate to continue 
in force until March 31, 1937, unless revoked at an earlier date. 
1/we agree, that should the tangible personal property purchased under this certifi¬ 
cate be determined to be taxable, that 1/we shall be subject to the levy provided by law 
Signed 
By 
Title 
If a vendor, 
insert Vendor's 
License 
Date . No. 
NOTE: The vendor must support all individual sales made under this certificate by a 
separate invoice or record, showing a description of article or articles, price for each 
item, and total amount involved in each transaction. 
The purpose for which, or the purchaser by whom, the items are purchased, must be 
checked or written in; otherwise, this certificate is void. 
Section 5546-9a of the General Code provides for assessment against purchasers who 
give a false or erroneous certificate. 
Section 5546-15a of the General Code provides that giving a false certificate is a 
misdemeanor. 
♦Interstate commerce exemption shall be taken by the vendor and claimed by the 
consumer only when the contract of sale requires the movement in interstate com¬ 
merce of the property sold. 
