SU07-58 
                                                      STATE OF         RHODE     ISLAND 
                                                      DEPARTMENT            OF REVENUE 
                                                        DIVISION       OF   TAXATION 
                                                                            
                                                            SALES  AND      USE     TAX 
                                      MANUFACTURER’S               EXEMPTION            CERTIFICATE 
                                                                            
NAME OF SELLER :______________________________________    DATE ___________________ 
 
ADDRESS OF SELLER____________________________________________________________ 
 
UNDER PENALTIES OF PERJURY   ,HEREBYI         CERTIFY THAT THE  PROPERTY HEREIN DESCRIBED  IS PURCHASED  FOR THE FOLLOWING INDICATED 
PURPOSE AND IS EXEMPT FROM THE SALES OR USE TAX PURSUANT TO            CHAPTER   18,  ECTIONS 30 (7) OR (22) OF THE RHODE ISLAND SALES AND 
USE TAX LAW: 
 
        1.           [] THE PROPERTY DESCRIBED BELOW IS PURCHASED FOR THE PURPOSE OF BEING MANUFACTURED IN THIS 
                        STATE INTO A FINISHED PRODUCT FOR RESALE AND BECOMES A RECOGNIZABLE ,   INTEGRAL PART OF SUCH 
                        FINISHED PRODUCT. 
         
        2.            [] THE PROPERTY DESCRIBED BELOW WILL BE USED IN THIS STATE IN AN  INDUSTRIAL PLANT IN THE ACTUAL   
                        MANUFACTURE ,CONVERSION ,OR  PROCESSING OF TANGIBLE PERSONAL PROPERTY ,OR TO THE EXTENT         
                         USED IN CONNECTION WITH THE ACTUAL MANUFACTURE ,CONVERSION  OR PROCESSING OF COMPUTER 
                        SOFTWARE AS THAT TERM IS UTILIZED  IN INDUSTRY NUMBERS7371,   7372 AND 7373 IN THE STANDARD 
                         INDUSTRIAL  CLASSIFICATION ,OFFICE OF STATISTICAL STANDARDS ,EXECUTIVE OFFICE OF THE PRESIDENT ,  
                        UNITED STATES BUREAU OF THE BUDGET ,AS REVISED FROM TIME TO TIME  TO, BE SOLD  OR, USED IN THE   
                        FURNISHING OF POWER TO AN  INDUSTRIAL MANUFACTURING PLANT. 
 
DESCRIPTION     OF           PROPERTY : ________________________________________________________________ 
 
________________________________________________________________________________________ 
 
________________________________________________________________________________________ 
 
________________________________________________________________________________________ 
 
IF THE TANGIBLE PERSONAL PROPERTY UNDER  THIS CERTIFICATE IS USED TO ANY EXTENT IN A TAXABLE MANNER     WE ,AGREEI (       )TO FILE THE 
APPROPRIATE USE TAX RETURNS AS REQUIRED BY REGULATION           SU 07-58 AND THE RHODE  SLANDI  SALES AND USE TAX LAW    . 
 
NAME OF PURCHASER ___________________________________________________________ 
 
ADDRESS OF PURCHASER           _______________________________________________________ 
 
                                 _____________________________________________________
 
SIGNATURE OF PURCHASER OR AGENT _______________________________________________ 
 
IF CORPORATION GIVE NAME AND TITLE OF CORPORATE OFFICER __________________________ 
 
CHECK APPLICABLE       :      SINGLE PURCHASE CERTIFICATE           [  ] 
             BLANKET CERTIFICATE                             [         ] 
 
                          THIS FORM IS APPROVED BY THE DIVISION OF TAXATION AND MAY BE REPRODUCED