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C-721 Clear form Rev. 12/07 Telephone Number Street Address City Authorized Signature Print Form State Name (please print) ZIP Code Title Date Name of Seller or Supplier: The person signing this certificate MUST check the applicable box showing the basis for which the exemption is being claimed. Questions should be directed (preferably in writing) to Taxpayer Services, Utah State Tax Commission, 210 N 1950 W, Salt Lake City, UT 84134. Telephone (801) 297-2200, or toll free 1-800-662.

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