Department Requester:
Date: Extension:
Requester Email:
VENDOR INFORMATION
* Required
Vendor Name:
*
Address:
*
City, St, Zip:
*
Phone: ( )
*
Fax: ( )
*
Vendor Email Address:
*
Reference Info:
*
The certificate will be processed and sent directly to the vendor. Requester will receive notification
upon completion of request.
Additional Comments:
revised 4/3/18
Fax to: Purchasing Dept., Ext. 3810 or Scan and Email to: vantanee.sangpu@southeastern.edu
Request for Tax Exemption Certificate
PO#, SO#, Customer #
***FOR INTERNAL USE ONLY***
To be Completed and Forwarded to Purchasing by SELU Requester
Tax Exemption DOES NOT apply to travel expenses. For more information, refer to La. State Travel Guidelines,
PPM-49, or contact the SLU Travel Desk @ 2088.
Preferred Method To Send
Instructions: Complete form ONLINE, print and fax; or print, scan & email.