TAX EXEMPT NO. 93-0386945-F

EXEMPTION CERTIFICATE FOR GOVERNMENT AGENCIES

TAX ON OCCUPANCY OF HOTEL/MOTEL ROOMS

___________________________________________________________

(Name of hotel, motel, etc.)

_____________________________________________________________ Date:_______________

(Address)

This is to certify that I, the undersigned, am a representative or employee of the USDA Forest Service; that the charges for the occupancy at the above establishment on the dates set forth below have been, or will be, paid for by the USDA Forest Service; and that such charges are incurred in the performance of my official duties as a representative or employee of the USDA Forest Service. 

DATES OF OCCUPANCY:_________________________________________________________

SIGNATURE:________________________________

Operators of hotel, motel, etc., should not accept this certificate unless the officer or employee presenting it shows satisfactory credentials.

Note: A separate exemption certificate is required for each occupancy and for each representative.