Form R-1372 - Application For Sales/use Tax Exclusion - 1997
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1State of Louisiana
R-1372 (2/97)
Department of Revenue and Taxation
Sales Tax Division
P.O. Box 3863
Baton Rouge, LA 70821-3863
(504) 925-7356
Application for Sales/Use Tax Exclusion
on purchases, leases, or rentals by parochial and private elementary and secondary schools
Make sure the application is complete. Processing will be delayed or the exclusion denied if you do not provide the
requested documents.
Name of school ___________________________________________________________________________________
Represented by __________________________________ Title ____________________________________________
Address _________________________________________________________________________________________
City, State, ZIP ___________________________________________________________________________________
(
)
Parish _______________________ Daytime telephone number____________________________________________
Does the school maintain educational standards established by the State Department of Education?
Yes
No
(Attach a copy of the State Department of Education’s current academic certification letter.)
Is the school in compliance with Brumfield v. Dodd ?
Yes
No
(Attach a copy of the State Department of Education’s letter of official notification.)
Is the school presently recognized as exempt from Federal Income Taxes?
Yes
No
(Attach a copy of the IRS’ determination letter for Section 501(c)(3) exempt status.)
Under the penalties of perjury, I declare that I am authorized to sign this application on behalf of the above school and that
I have examined this application, and to the best of my knowledge it is true, correct, and complete.
Signature
Date
For Department use only.
Approved
Signature
Date
Disapproved
Signature
Date
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