Rule 90.
CERTIFICATE IS TO BE EXECUTED WHEN TAX EXEMPT SALE IS MADE TO AN EXEMPT INSTITUTION OR AGENCY
The undersigned hereby certifies that the item or items being purchased are to be used or consumed in connection with the operation of the exempt institution or agency named in the space provided below, and that the consideration for this purchase moves from the funds of the designed institution or agency. In the event this claim is disallowed, the transferee promises to reimburse the seller for the amount of tax involved.
Date __________________
_________________________________________________
Name of exempt institution or agency
_________________________________________________
Signature and title of person making certification
Mich. Admin. Code R. 205.140