Washington State Department of Revenue

MOTION PICTURE AND VIDEO PRODUCTION

BUSINESS EXEMPTION CERTIFICATE
  1. Name of Seller: Absolute Digital Broadcast Rentals
  2. Name of Renter/Buyer _____________________________________________
  3. Address of Renter/Buyer __________________________________________
  1. Renter/Buyers’ Washington State UBI/Revenue Registration Number (Not Federal ID number or Social Security number or Business License number. Leave intentionally blank if you are not required by State regulation to have a UBI number)

    ________ - ________ - _________

     

  2. Production Equipment Rented: Equipment, which may include in part grip and lighting equipment, cameras, tripods, jib arm, steadicams, and other camera mounts, cranes, dollies, generators, walkie talkies, vans/trailers/trucks specifically equipped for motion picture or video production, special effects equipment, video tape recorders, cables and connectors, sound recording equipment rented for motion picture or video production, and if applicable,

    ________________________________________________________________
  3. Production Services Purchased: Not Applicable

The renter/buyer certifies that it is a motion picture or video production business as defined in ESHB 1913 as a person (including a sole proprietorship, partnership, corporation, or other form of business organization) engaged in the production of motion pictures and video tapes for exhibition or sale, or for broadcast by someone other than the person producing the motion picture or video tape, and that it is not engaged, to any extent, in the production of erotic material, as defined in RCW 9.68.050.

Print Name of Person Authorized by the Renter/Buyer to Sign this Certificate

Mr/Ms ____________________________________________________________

Signature of above __________________________________________________

Dated Signed _____/_____/200___

A signed copy of this certificate can be returned to:

Absolute Digital Broadcast Rentals  3301 172nd Ave N.E.    Bellevue , WA 98008  Phone: 206-768-9828   Fax: 425-861-9743

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