Blanket Certificate Of Exemption Covering Purchases For Resale Or For Further Processing Template

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BLANKET CERTIFICATE OF EXEMPTION

COVERING PURCHASES FOR RESALE OR FOR FURTHER PROCESSING

Date _______________________________

Purchaser_____________________________________________________________________________________

Address ______________________________________________________________________________________

Local Sales Tax Account Number ___________________________ LA Account Number: ___________________

(Both account numbers are required)

Type of Property to be resold _____________________________________________________________________

This certifies that all goods purchased from the Seller listed below are to be used for resale or further processing and are,

therefore, exempt from the provisions of the Bossier City- Parish Sales & Use Tax Division and the Uniform Local Sales Tax

Code.

Name of dealer making sale (Seller) _______________________________________________________________

Address ______________________________________________________________________________________

Purchaser hereby agrees that should this sale be later held subject to tax, purchaser assumes full liability for the tax.

______________________________________

______________________ ____________________________

Signature of Purchaser

Title

Telephone

Any purchaser and/or agent who fraudulently signs this certificate without intent to use the property or services purchased as

above stated is subject to all the penalties provided for by Title 47 of the Louisiana Revised Statutes of 1950. This certificate

will remain in effect until withdrawn by the purchaser, or the purchaser’s sales tax account is closed, or the purchaser’s ability

to make tax-free purchases is amended or revoked by the Bossier City-Parish Sales & Use Tax Division.

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SALES & USE TAX EXEMPTION CERTIFICATE INSTRUCTIONS

Use this form to claim exemption from sales tax on purchases of taxable items. The purchaser must complete all fields on the exemption certificate and

provide the fully completed certificate to the seller in order to claim exemption.

Purchaser: You are responsible for ensuring that you are entitled to the exemption you are claiming.

It is your responsibility to inform the seller if any part

of the transaction is

taxable.

You will be held liable for any tax and interest, as well as penalties imposed by the Bossier City-Parish Sales & Use Tax

Division, if you are not eligible to claim this exemption.

Seller: You are required to keep a copy of this exemption certificate in your files and provide information on the purchaser to any local taxing jurisdiction

upon request. You are relieved of the responsibility for collecting and remitting sales tax on the sale or sales described on the exemption certificate, provided

all of the following conditions are met:

all fields on the exemption certificate are completed by the purchaser.

the fully completed exemption certificate is provided to you at the time of the sale; and

you do not fraudulently fail to collect the tax due or solicit customers to unlawfully claim an exemption.

Complete the purchaser and seller information section. An identification number for your business must be included. Also, include your state tax

identification number.

This is a local exemption only; state sales tax may apply. A separate state sales tax exemption is required. This exemption applies to the local sales tax only

and cannot be used to exempt the State of Louisiana sales tax.

Proud member of LATA

Rev 09/04

Blanket Certificate of Exemption.doc