Form R-1013 - For-Hire Carrier Blanket Certificate - 1997
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1State of Louisiana
R-1013 (4/ 97)
LGST-12
Department of Revenue and Taxation
P. O. Box 201 Baton Rouge, LA 70821-0201
For-Hire Carrier Blanket Certificate
for use by for-hire carriers operating in interstate or foreign commerce
under the Louisiana sales tax law (Revised Statute 47:301 et seq.)
Date ____________________________________, 19_____
This certifies that all materials, equipment, goods, or merchandise purchased by the undersigned from:
Name
_________________________________________________________________________________________________________
Address _________________________________________________________________________________________________________
are to be used or consumed in the undersigned’s business of transporting passengers or property for hire in interstate or foreign commerce,
and that all tax due will be paid by the undersigned directly to the Department of Revenue and Taxation, under the provisions of
R.S. 47:306.1, as amended. The undersigned further certifies that this tax treatment has been elected by the taxpayer.
Registration cer tificate number ______________________________________________________________________________________
Signature of purchaser _____________________________________________________________________________________________
Address _________________________________________________________________________________________________________
City, State, ZIP ____________________________________________________________________________________________________
Any purchaser who fraudulently signs this certificate without intent to use the proper ty or services purchased as stated above will be subject
to all penalties provided by law. This cer tificate may not be offered or accepted in lieu of the tax on lease or rental transactions or on repair
or other service transactions.
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