Form R-1355 - Exemption Certificate

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R-1355 (2/07)
Exemption Certificate
Covering purchases of tangible personal property
for resale by a blind person in the conduct of a
business as provided by Revised Statutes 47:305.15
This certifies that the purchaser is a blind person who is making purchases for resale in
the conduct of a business that is exempt from license taxes by R.S. 46:371 through
46:373, and is entitled to make purchases exempt from the payment of advance sales
tax, provided sales tax is not charged to customers upon resale of the merchandise.
The blind person certifies the following:
• The business is conducted by the blind person exclusively for his own support or
for the support of his family;
• The value of the business’s stock of goods on hand, or equipment or capital
stock never exceeds $2,000;
• The business does not deal in the sale, trade, or traffic of deadly weapons or any
illegal articles; and
• The business does not operate as a place of amusement.
The undersigned purchaser further agrees that should the sale later be held subject
to the sales tax, the purchaser assumes full liability for payment of the tax, penalty,
and interest.
PLEASE PRINT OR TYPE.
Signature of Blind Person
Date (mm/dd/yyyy)
X X
Qualifying Blind Person
Address
City
State
ZIP
Any purchaser who fraudulently signs this certificate without intent to use the
property as above stated shall be subject to all penalties provided by Title 47 of
the Louisiana Revised Statutes.

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