R-1332 - Blanket Exemption Certificate

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R-1332 (4/05)
Blanket Exemption Certificate
covering purchases of telecommunication services
for resale by another service provider under
Revised Statute 47:301(14)(i)
This certifies that all telecommunication services purchased by the undersigned from:
Name: ______________________________________________________________________________________________________
Address: ____________________________________________________________________________________________________
are to be resold and are exempt from the collection of the advance sales tax provision of R.S. 47:306(B). The undersigned purchaser fur-
ther certifies that the services which are hereby claimed to be exempt will be resold at retail and that the sales tax will be collected and
remitted to the Department of Revenue and Taxation under the sales tax registration account number listed below.
______________________________________________________
__________________________________________________
Purchaser
Signature of authorized agent
______________________________________________________
__________________________________________________
Address
Title
______________________________________________________
__________________________________________________
Louisiana sales tax account number
Date

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