Form R-1006-L - Certificate Of Exemption

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State of Louisiana
R-1006-L (7/03)
Department of Revenue
Certificate of Exemption
covering purchases of food products for preparation
and consumption in the home
Date
This is to certify that the food products purchased from
whose address is____________________________________________________________________________________________ will be
resold, the majority of my sales will be for preparation and consumption by the final purchaser in the home or location other than a restau-
rant, drive-in, snack bar, candy and nut counter, private club, or other food service facility selling prepared food for on-premises or off-
premises consumption and not to be dispensed through coin-operated vending machines.
Effective January 1, 2003 through June 30, 2003, my purchases of food products are subject to the Louisiana state sales tax at the rate
of 2% and effective July 1, 2003, my purchases of food products are fully exempt, in accordance with House Bill 31 of the 2002 Regular
Session of the Louisiana Legislature as approved by the voters in a general election in November 2002. I understand that any misuse
of this certificate by the seller or the purchaser will subject either party to the criminal or civil penalties provided for in the Louisiana
Revised Statues.
Name of purchaser
Address
City, State, ZIP
Signature of purchaser or authorized agent
This certificate cannot be used for purchases of food products for use by the purchaser for other than the purposes set forth above.
"Food for preparation and consumption in the home" is defined in regulation LAC 61:I. 4401, available on the Department of Revenue's
website at A reseller of food products may execute the certificate only if the majority of the food purchased in any
transaction will be resold for use by the final retail purchaser for the purpose set forth above. The issuer must withdraw the certificate
when these criteria are no longer met.
A seller cannot accept this certificate in lieu of the payment of the state sales and use tax by a vending machine operator, restaurant,
drive-in, snack bar, candy and nut counter, private club, or other food service facility selling prepared food for on-premises or off-prem-
ises consumption. Neither can the certificate be accepted on sales of alcoholic beverages, malt beverages and beer, distilled water, water
in containers, or carbonated water.

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