To be retained by vendor as TAX EXEMPTION CERTIFICATE
Evidence of exempt sale
__________________________________________________________________ Date ______________________________________
Name of Person of Firm furnishing services and/or materials
______________________________________________________________________________________________________________
Address
This is to certify that I am an employee of the State of New York or one of its political subdivisions; that the services or materials purchased on the
date set forth below will be paid for by the State or a political subdivision; and that such charges are incurred in the performance of my official
duties.
Nature of Transactions _____________________________ Signature of Employee _______________________________________________________
Dates of Transactions ______________________________ Title ________________________________________________________
State Dept., Agency or
Political Subdivision: Orange County Community College ID#: 14-6004242
115 South Street
Middletown, NY 10940
STATE OF NEW YORK
For Use Only by Employees of the State of New York
Or its political subdivisions
AC 946 (Rev. 11/70) Print Code X
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