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Form R-1345 - Application Form By Seafood Processing Facility For Exemption From Louisiana Sales And Use Taxes - Taxpayer Services Division Of Department Of Revenue Of State Of Louisiana

R-1345 (2/03)

State of Louisiana

Department of Revenue

Taxpayer Services Division

P. O. Box 201

Baton Rouge, LA 70821-0201

Application by Seafood Processing Facility for Exemption from

Louisiana Sales and Use Taxes

Please print or type.

Name

__________________________________________________________________

Mailing address

__________________________________________________________________

Location address (if different)

__________________________________________________________________

City, State, ZIP

__________________________________________________________________

Louisiana Sales Tax Account Number

__________________________________________________________________

I do hereby apply for a certificate of exemption from Louisiana state sales and use taxes under Louisiana Revised Statute

47:305.20 and make the following statements:

I own, lease, or have exclusive contracts with commercial fishing vessels that have been qualified by the Department of

Revenue as being entitled to a sales tax exemption.

Please complete either A, B, or C.

My owned vessel is named ____________________________________, and has a registration/document number of

____________________________________. The Department of Revenue Exemption Certificate Number issued for

this vessel is ____________________________________.

My leased vessel is named ____________________________________, and has a registration/document number of

___________________________________. The Department of Revenue Exemption Certificate Number issued for this

vessel is ____________________________________.

C. I have an exclusive contract with ________________________________________ to purchase all of the catch from

____________________________, the registration/document number of which is ____________________________,

Vessel name

for the period of _________________________________. The Department of Revenue Exemption Certificate Number

List dates

issued for this vessel is __________________________________.

I understand that exemption from state sales taxes is valid only as long as I am a seafood processor who meets all of the

requirements for the exemption.

I understand that the exemption certificate issued by the Department of Revenue may not be transferred to any other seafood

processor.

Signature

Date

Sworn to and subscribed before me this __________ day of _______________________________________ __________

Year

Notary Public

Note: This application must be accompanied by a copy of the lease contract for any vessel that is listed in B above and a

copy of the exclusive purchase contract for any vessel listed in C above.

Form R-1345 - Application Form By Seafood Processing Facility For Exemption From Louisiana Sales And Use Taxes - Taxpayer Services Division Of Department Of Revenue Of State Of Louisiana

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