Form REV62 0077E "Purchaser Certification for Export Restricted Timber" - Washington

What Is Form REV62 0077E?

This is a legal form that was released by the Washington State Department of Revenue - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 8, 2012;
  • The latest edition provided by the Washington State Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form REV62 0077E by clicking the link below or browse more documents and templates provided by the Washington State Department of Revenue.

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Download Form REV62 0077E "Purchaser Certification for Export Restricted Timber" - Washington

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State of Washington
Purchaser Certification For
Department of Revenue
PO Box 47472
Export Restricted Timber
Olympia WA 98504-47472
Reset This Form
1-800-548-8829
Contracting/Selling Agency:
Sale Name:
Date of Sale:
Agency Contract Number:
DNR Region:
County:
Forest Practices Application Number:
Legal Description: Sec/Twp/Rge:
Estimated Sale Volume:
Unit of Measure: MBF Scribner, Weight (pounds, tons), Cords, Other
Assigned Log Brand Description:
Registered Log Brand Number:
The Purchaser hereby affirms, under penalty of law, the truth of the following:
A. That export restricted unprocessed timber will not be:
 Exported by the Purchaser or used in substitution by the Purchaser, or
 Transferred to any other person for the purpose of export or substitution.
B. That hammer brands and red paint applied to such timber as required by WAC 240-15-025 shall remain
on such timber until it is domestically processed.
C. That prior to selling, trading, exchanging, or otherwise conveying export restricted timber to any other
person, the purchaser (transferor) shall require the transferee to sign a completed Transferee
Certification. The original is to be mailed to Department of Revenue prior to the logs being physically
transferred.
D. That the transferor shall not sell, trade, exchange or otherwise convey export restricted timber to any
other person on the Department of Revenue ineligible list.
Making false statements on the Bidder Certification is punishable as a gross misdemeanor
RCW 9A.72.040.
Purchaser’s Name:
Address:
City, State, Zip Code:
Phone Number:
FAX Number:
UBI Number:
Timber Tax Number:
Representative’s Name/Title:
Representative’s Signature:
Date:
Distribution:
White - Department of Revenue
Canary - Contracting Agency
Pink - Purchaser
1
REV 62 0077e (w) (3/8/12)
Print This Form
State of Washington
Purchaser Certification For
Department of Revenue
PO Box 47472
Export Restricted Timber
Olympia WA 98504-47472
Reset This Form
1-800-548-8829
Contracting/Selling Agency:
Sale Name:
Date of Sale:
Agency Contract Number:
DNR Region:
County:
Forest Practices Application Number:
Legal Description: Sec/Twp/Rge:
Estimated Sale Volume:
Unit of Measure: MBF Scribner, Weight (pounds, tons), Cords, Other
Assigned Log Brand Description:
Registered Log Brand Number:
The Purchaser hereby affirms, under penalty of law, the truth of the following:
A. That export restricted unprocessed timber will not be:
 Exported by the Purchaser or used in substitution by the Purchaser, or
 Transferred to any other person for the purpose of export or substitution.
B. That hammer brands and red paint applied to such timber as required by WAC 240-15-025 shall remain
on such timber until it is domestically processed.
C. That prior to selling, trading, exchanging, or otherwise conveying export restricted timber to any other
person, the purchaser (transferor) shall require the transferee to sign a completed Transferee
Certification. The original is to be mailed to Department of Revenue prior to the logs being physically
transferred.
D. That the transferor shall not sell, trade, exchange or otherwise convey export restricted timber to any
other person on the Department of Revenue ineligible list.
Making false statements on the Bidder Certification is punishable as a gross misdemeanor
RCW 9A.72.040.
Purchaser’s Name:
Address:
City, State, Zip Code:
Phone Number:
FAX Number:
UBI Number:
Timber Tax Number:
Representative’s Name/Title:
Representative’s Signature:
Date:
Distribution:
White - Department of Revenue
Canary - Contracting Agency
Pink - Purchaser
1
REV 62 0077e (w) (3/8/12)
Print This Form
Purchaser Certification Instructions
This form is used for reporting direct acquisitions
Assigned Log Brand Description: Enter the log
by companies or individuals of unprocessed
brand assigned to the sale or contract.
export restricted timber from public agencies. A
Registered Log Brand Number: Enter the State
separate Certification form is needed for each
Log Brand Registry identification number for the
contract or agreement. Completed forms are to be
assigned log brand.
submitted to the Department of Revenue at the
address listed below within five days of the
Purchaser Information: Type or print purchaser’s
contract award date and before logging
name, mailing address, daytime phone number
activities begin.
(including area code), FAX number (if applicable),
UBI number (if you do not have a Washington
Contract/Selling Agency: Enter the public
State Unified Business number, enter your federal
agency offering the timber sale or public works
tax number), Timber Tax registration number, and
project up for bid.
representative’s name and title.
Sale Name: Enter the timber sale name assigned
Submit signed and dated certifications to the
by the selling agency.
following address:
Date of Sale: Enter the auction date for the sale
Washington State
or the date that the contract was signed.
Department of Revenue
Forest Tax Program
Agency Contract Number: Enter the contract
PO Box 47472
number assigned by the selling agency (if
Olympia WA 98504-7472
applicable).
Please note that incomplete forms will not be
DNR Number: For Department of Natural
accepted.
Resources contracts, enter the DNR region name.
If you need further assistance, please call
County: Enter the name of the county in which
1-800-548-8829.
the sale is located.
Forest Practice Application Number: Enter the
Department of Natural Resources Forest
Practices Permit number which corresponds with
the sale.
Estimated Sales Volume: Enter the volume of
timber being acquired (rounded to the nearest
whole number).
Unit of Measure: Enter the measurement unit for
the sales volume, MBF (thousand board feet),
weight (pounds, tons), cords, other (explain).
For tax assistance or to request this document in an alternate
format, please call 1-800-548-8829. Teletype (TTY) users
may use the Washington Relay Service by calling 711.
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REV 62 0077e (w) (3/8/12)
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