| HOSE & FITTINGS | ADAPTERS | LUBRICATION | REELS | EQUIPMENT | RESOURCES | ORDER FORM | CONTACT US |
HOSE LINE
6060 San Fernando Road
Glendale, California  91202 		Hose Line Corporation Phone:  (818) 547-3010
Fax:  (818) 547-3339
Sales@HoseLine.Net

RESALE CERTIFICATE
DATE:

 REFERENCE NUMBER:
COMPANY/ORGANIZATION:

PHONE:
FAX:
E-MAIL:

MAILING ADDRESS:
TOWN/CITY:
STATE/PROVINCE:
POSTAL/ZIP CODE:
COUNTRY:
I am engaged in selling/trading the following item(s):

 I shall purchase from:
  Hose Line..
The product I purchase will be resold under the sales tax rules and regulations. If product is used for any other way, I understand that I am required by law (local/provincial) to report and/or pay tax according to the cost of the item purchased. Description of property to purchase:
Seller's Permit Number:
Name & Title:

Signature & Date:

Copyright © 2001, Hose Line.  See HoseLine.Net for Terms & Conditions.
PRINT THIS FORM TO PAPER.