Form R-1334 - Application By Commercial Fisherman For Exemption From Louisiana Sales And Use Ta X E S

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Louisiana Department of Revenue

R-1334 (5/04)

Taxpayer Services Division

Sales Tax Section

P.O. Box 201

Baton Rouge, LA 7 0 8 2 1 - 0 2 0 1

Application by Commercial Fisherman for Exemption from

Louisiana Sales and Use Ta x e s

A separate application must be submitted for each vessel for which exemption is requested.

Please print or type.

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Issued by: ❑ W & F ❑ U . S . C . G .

Social Security Number (Federal ID Number if a corporation)

Vessel registration/document number

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N a m e

Name of vessel

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Mailing address

Louisiana vessel license number

Ye a r

(

)

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C i t y, State, ZIP

Telephone

I, a commercial fisherman, 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:

1 . I have lived in Louisiana since _____.

Year

2 . I hereby certify that I own/operate the vessel listed above that is used primarily and principally for commercial fishing.

3 . My total income from wages, salaries, tips, and net income from self-employment (for corporation, total net income) for

the last calendar year of _____ was $___________________ and, of this total, my income derived from comm e rcial

fishing was $____________________. I am aware that under R.S. 47:305.20, only those persons for whom commercial

fishing is their primary source of earned income are eligible for state sales tax exemption.

4 . I hold a valid commercial fishing license and my catch is for human cons u m pt i o n .

I understand that exemption from state sales taxes is valid only as long as I am a commercial fishe rman and meet all of the

requirements for the exemption.

I understand that if I knowingly use this certificate for a purpose other than that authorized by R.S. 47:305.20, I may be

subject to a fine of not less than $100 per offense, nor more than $1,000 per offense, and i m p r i so nment without hard labor

for not less than one day, nor more than three months.

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

other owner-operator or person.

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S i g n a t u r e

D a t e

Sworn to and subscribed before me this ______________ day of _____________________________________ _______

Ye a r

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Notary Public

This application must be accompanied by copies of a current vessel license, proof of vessel ownership, commercial fishing

license, and a complete copy of the most current federal income tax return. Proof of vessel ownership may be a copy of the

boat registration, or a copy of the U.S. Coast Guard documentation. The vessel license, owner of vessel, fishing license, and

federal income tax return must be in the same individual or corporation name.