Form R-1384 - Original Works Of Art Sold In An Established Cultural Product District Sales Tax Exemption Certificate

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R-1384 (6/08)
Original Works of Art Sold in an
Established Cultural Product District
Sales Tax Exemption Certificate
Revised Statute 47:305.57
Taxpayer Services Division
P.O. Box 201
Baton Rouge, LA 70821-0201
(225) 219-7356 (225) 231-6236 (Fax)
PLEASE PRINT OR TYPE.
Purchaser Name
Address
City
State
ZIP
Description of Art
Title
Artist Name
Media
Size
Color
Date Created
(if known)
Sales Price
Date of Purchase
(mm/dd/yyyy)
The Seller hereby certifies that the above described item is an original one of a kind work of art that meets the definition established by
the Louisiana Department of Culture, Recreation and Tourism. Its authenticity is attested to by the following authorized representative
of the Seller.
Seller Name
Seller Address
City
State
ZIP
Cultural Product District Name
Cultural Product District Parish
City
Authorized person completing the exemption certificate
Name
Title
Signature
Date
(mm/dd/yyyy)
X
Original exemption certificate to be retained by seller; copy of exemption certificate to be retained by purchaser.

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