Form R-1315 - Application For Sales Tax Exclusion For Purchases By Nonprofit Organizations That Train Or Employ Persons With Disabilities

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R-1315 (6/06)
Application for Sales Tax Exclusion for
Purchases by Nonprofit Organizations That
Train or Employ Persons with Disabilities
Taxpayer Services Division
P.O. Box 201
Baton Rouge, LA 70821-0201
(225) 219-7356
(225) 219-2065 (Fax)
Please Print or Type
1. Nonprofit Organization Name
2. Home Address
City
State
ZIP
3. Mailing Address
City
State
ZIP
4. Telephone Number
The above nonprofit organization hereby applies for the state and local sales tax exclusion for purchases by the organiza-
tion allowed by Revised Statute 47:301(8)(f). In applying for the sales tax exclusion, the organization certifies the following:
1.The organization is a bona fide nonprofit organization;
2.The nonprofit organization sells donated goods; and
3.Seventy-five percent of the organization’s revenues are spent directly on employing or training for employment persons
with disabilities or workplace disadvantages.
5. Name and title of officer entitled to make purchases on behalf of the organization.
Name
Title
6. Officer of the organization completing the application.
Print/Type Name
Title
Signature
Date
For Official Use
Approved.
Exclusion Certificate Expires annually on
,20
_______________________
________.
Disapproved
Signature of Department Representative
Date

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