Form R-1344 - Exemption Certificate - State Of Louisiana Department Of Revenue
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1R-1344 (12/02)
State of Louisiana
Department of Revenue
Exemption Certificate
covering purchases of tangible personal property for rent or lease, other than motor vehicles,
under Louisiana Revised Statute 47:301(10)
This certifies that the tangible personal property purchased from____________________________________________________________
Seller/vendor
is to be offered for rent or lease in an arm’s length transaction. This also certifies that the gross proceeds received from the rent or lease of
the property will be subject to all applicable rental tax that must be remitted. It is understood that any use of the property for purposes other
than rent or lease in an arm’s length transaction will subject the property to a sales/use tax liability on its cost or fair market value at the time
of such other use.
Type of property purchased for rent or lease ____________________________________________________________________________
______________________________________________________
____________________________________________________
Purchaser
Signature of authorized agent
______________________________________________________
____________________________________________________
Address
Title
______________________________________________________
____________________________________________________
City, State, ZIP
Date
______________________________________________________
____________________________________________________
Louisiana sales tax account number
Parish sales tax account number
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