State Of Louisiana - Surplus Property Purchase Agreement And Certification Form Page 4

ADVERTISEMENT

STATE OF LOUISIANA - SURPLUS PROPERTY
New
Update
PURCHASE AGREEMENT AND CERTIFICATION
I declare and state that I have read and understand the rules and regulations governing the
purchase of surplus property as set forth in the Louisiana State Property Control Regulations
under the provisions of Title 39:330 of the Louisiana Revised Statutes of 1950.
DATE:___________________________________________
EIN: _____________________________________
PURCHASING AGENCY, INSTITUTION, OR ORGANIZATION:
_______________________________________________________________________________________________
MAILING ADDRESS: __________________________ CITY: _________________ STATE: _____ ZIP: __________
PHYSICAL ADDRESS: ________________________ CITY: _________________ STATE: _____ ZIP: __________
TELEPHONE: (
)
FAX: _(_______)_______________________________
The following person(s) are authorized to purchase state surplus property:
1. NAME: __________________________________________________________________________________
STREET:_________________________________________________________________________________
CITY, STATE, ZIP:_________________________________________________________________________
EMAIL ADDRESS:_________________________________________________________________________
DRIVER’S LICENSE #:______________________________________________________________________
2. NAME:___________________________________________________________________________________
STREET:_________________________________________________________________________________
CITY, STATE, ZIP:__________________________________________________________________________
EMAIL ADDRESS:__________________________________________________________________________
DRIVER’S LICENSE #:______________________________________________________________________
3. NAME:___________________________________________________________________________________
STREET:_________________________________________________________________________________
CITY, STATE, ZIP:_________________________________________________________________________
EMAIL ADDRESS:_________________________________________________________________________
DRIVER’S LICENSE #:______________________________________________________________________
4. NAME:___________________________________________________________________________________
STREET:_________________________________________________________________________________
CITY, STATE, ZIP:_________________________________________________________________________
EMAIL ADDRESS:__________________________________________________________________________
DRIVER’S LICENSE #:______________________________________________________________________
5. NAME:___________________________________________________________________________________
STREET:_________________________________________________________________________________
CITY, STATE, ZIP:_________________________________________________________________________
EMAIL ADDRESS:__________________________________________________________________________
DRIVER’S LICENSE #:______________________________________________________________________
Should there be any changes in the authorized buyer’s list, please send this agency the updated information.
DATE:_________________________________________
SIGNED:________________________________________________________________________________________
AGENCY HEAD / PRESIDENT / CHAIRMAN OR COMPARABLE AUTHORIZED OFFICIAL
(Rev. 02/2016)
Page 4 of 4

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

State Of Connecticut Employment Security Division Prevailing Wage Request Form State Of Connecticut Employment Security Division Prevailing Wage Request Form Business
State Of Delaware Authorization For Release Protected Health Information Form State Of Delaware Authorization For Release Protected Health Information Form Legal
Form R-1368 - Certification Of The Purchase Of Motor Boats In Louisiana That Are To Be Registered In Another State And Are Made By A Nonresident - State Of Louisiana Department Of Revenue Form R-1368 - Certification Of The Purchase Of Motor Boats In Louisiana That Are To Be Registered In Another State And Are Made By A Nonresident - State Of Louisiana Department Of Revenue Financial
Form Lgst 9-d - Exemption Certificate (foreign Purchasers) Under Louisiana General Sales Tax Law R.s. 47:305.10 - Department Of Revenue Of State Of Louisiana Form Lgst 9-d - Exemption Certificate (foreign Purchasers) Under Louisiana General Sales Tax Law R.s. 47:305.10 - Department Of Revenue Of State Of Louisiana Financial
Form R-1059 - Sales Tax Exemption Certificate For Boys State Of Louisiana, Inc. And Girls State Of Louisiana, Inc. Form R-1059 - Sales Tax Exemption Certificate For Boys State Of Louisiana, Inc. And Girls State Of Louisiana, Inc. Financial
Form R-3001-l - Louisiana Report Of Unclaimed Property Verification And Checklist - State Of Louisiana Form R-3001-l - Louisiana Report Of Unclaimed Property Verification And Checklist - State Of Louisiana Financial
Form R-1056 - Certifi Cate Of Sales/use Tax Exemption/ Exclusion Of Purchases By Political Subdivisions Of The State Of Louisiana Form R-1056 - Certifi Cate Of Sales/use Tax Exemption/ Exclusion Of Purchases By Political Subdivisions Of The State Of Louisiana Financial
Form R-1346 - Exemption Certificate - State Of Louisiana Department Of Revenue And Taxation - 1997 Form R-1346 - Exemption Certificate - State Of Louisiana Department Of Revenue And Taxation - 1997 Financial
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 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 Financial
Form R-9009-l - Summary Of Open Market Timber Purchases - State Of Louisiana Form R-9009-l - Summary Of Open Market Timber Purchases - State Of Louisiana Financial

Related Categories

Parent category: Business
Download
Go
Page of 4