STATE OF CALIFORNIA
CERTIFICATION OF EXEMPTION FOR MOBILEHOME RESIDENCE PURCHASE
BOARD OF EQUALIZATION
I hereby certify that the mobilehome that I
(PRINT NAME OF PURCHASER)
am purchasing from
(PRINT NAME OF RETAILER-CONSUMER)
is being purchased for occupancy as a residence and that it will only be used for this purpose. I further certify and agree that if the property purchased under authority of this certificate is used for any other purpose, I shall be liable for payment of tax measured by the entire sales price or gross receipts from the sale to me less an amount equal to 75 percent of the sales price of gross receipts from the sale of the mobilehome to the retailer.
DATE CERTIFICATE GIVEN
SIGNATURE OF PURCHASER
CAPACITY DESCRIPTION OF PROPERTY
CERTIFICATION OF EXEMPTION
To qualify for this special tax treatment, the dealer is required to secure and retain written certification at the time of the sale that the mobilehome will be installed for occupancy as a residence. If a purchaser issues such certification to a dealer and subsequently uses the property for other than a residence, the purchaser shall be liable for payment of tax measured by the purchaser's entire purchase price of the mobilehome, less 75 percent of the sales price paid by the dealer to the supplier for the mobilehome.