Online 4% Tax Form l Greene's Gas, Bay City, Michigan

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	s Greene's Gas, Inc
	a
	A Business Of Integrity

Main Office
2625 S Huron Rd
Kawkawlin, MI. 48631
Ph: (989) 684-3701
Fax: 989-684-4195
Email Us

Call Us Today!

Residential
Services

Construction Heat Services

Underground
Tanks

Cylinders & Forklift
Division

Dear Greene’s Gas Company Customer,

To apply for your 4% Tax Status, please complete the online form below. If you have any questions, please feel free to contact us via email, phone, or in person.

Thank you for your business!

Thank you for using
Greene's Gas!

Online 4% Sales Tax Form

Certification for Home Heating Fuel
for Residential Use

The Undersigned hereby certifies that the fuel being purchased is to be used and consumed for residential home use, and, therefore, qualifies for the 4% tax rate. In the event that the certification is disallowed, the transferee promises to reimburse the seller for the amount of tax at the 6% tax rate.

Please Complete The Following Form.
We Will Respond ASAP To Your Inquiry!

Online 4% Tax Form
Billing Information
First Name:
Last Name:
Address:
City:
State:
Zip Code:
Delivery Information
Contact Person
Delivery Address
Delivery City
State
Zip
Telephone
Usage Question
Square Footage Of Residence
Propane Appliances In Use	Furnace Water heater Cook stove Clothes dryer Other (Please Enter Below)
Contact Information
Phone:
Secondary Phone:
Best Time To Call:
Email:
Retype Email To Confirm:
Questions/Comments:

When Completed, Please Click On The
"Submit" Button. We Will Contact You
Promptly. Thanks For Your Response!

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If you have any questions, feel free to contact one of our
customer services representatives by phone or email.

	Greene's Gas, Inc
	a
	A Business Of Integrity

Serving Bay, Arenac, And Tuscola Counties
Since 1958