R-1072 - Manufacturer'S Designation Of Mandate Form Louisiana

Download a blank fillable R-1072 - Manufacturer'S Designation Of Mandate Form Louisiana in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete R-1072 - Manufacturer'S Designation Of Mandate Form Louisiana with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

Louisiana Department of Revenue

R-1072 (7/04)

Manufacturer’s Designation of Mandate (Agency)

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _, a person whose principal

(Legal name of Manufacturer)

activity is the manufacturing or producing of tangible personal property for sale and who has been assigned by the

Louisiana Department of Labor a North American Industrial Classification System (NAICS) code within the agricultural,

forestry, fishing and hunting Sector 11 or the manufacturing Sectors 31-33 as they existed in 2002, does hereby designate

the following person as its mandatary for the purpose of making purchases, leases, and rentals of manufacturing

machinery and equipment:

(Name)

(Address)

(City, State, ZIP)

This designation of mandate shall be effective for purchases, leases, and rentals of manufacturing machinery and

equipment to be used by the designating manufacturer predominantly and directly in manufacturing or producing tangible

personal property or agricultural products for sale. The manufacturing machinery and equipment will be used at a plant

facility whose address is:

(Mark one.)

❏

The designated mandatary is not restricted as to vendor.

❏

The designated mandatary is restricted to purchases from the following vendor:

The designation of mandate is for the period of _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _, through _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.

Purchases, leases, and rentals of tangible personal property during this period by the mandatary for use at this

manufacturing location shall be considered as the legal equivalent of purchases directly by the designating manufacturer.

Should such tangible personal property ultimately be used other than predominately and directly in the manufacturing of

tangible personal property or agricultural products for sale, the designating manufacturer and/or the designated mandatary

will be liable for the tax. The mandatary is not authorized to delegate this purchasing authority to others; separate

designations of mandate by the manufacturer are required for each person who is to purchase eligible manufacturing

machinery and equipment on behalf of the manufacturer. The undersigned hereby certify that this designation is the

entirety of the mandate contract between them.

Designation of Mandate:

Acceptance of Mandate:

(Signature of Authorized Designator and Date)

(Signature of Mandatary’s Authorized Acceptor and Date)