Louisiana Purchases for Resale by Foreign Purchaser

Purchases for Resale by Foreign Purchaser	
R-1079
R-1079 (3/19)

Purchases for Resale by Foreign Purchaser
Sales Tax Exemption Certificate
Louisiana Revised Statute 47:301(10)(a)(i)

PLEASE PRINT OR TYPE

Purchaser Information
Legal Name

Business Name

Mailing Address

City

State/Province/Region

ZIP/Postal Code

Country

State/Province/Region

ZIP/Postal Code

Country

Location Address

City

Please provide the following information:
Domicile State/Province/Region

Domicile License Number

Domicile Country

Domicile Tax Account Number

Please check appropriate box:

Retail license number 	

Wholesale license number	

Manufacturer’s license number

This certifies that all tangible personal property bought by the above-named purchaser is to be transported beyond the territorial limits
of the State of Louisiana to be resold or further processed into new articles for sale at retail. Purchases for resale or further processing
are exempt from state sales tax under the provisions of Louisiana Revised Statute 47:301(10)(a)(i). The purchaser hereby agrees that
should this sale later be held subject to state sales tax, the purchaser assumes full liability for such tax.
Seller Information
Seller Name

Location Address

City

State

Zip

Notice to Seller: This certificate should not be accepted by the seller unless proof of registration or license number held by the outof-state dealer is furnished to the Louisiana seller. If the dealer is located outside of the country, a statement with attestation must be
attached. Also, report this sale on Form R-1029, Louisiana Sales Tax Return, Schedule A, Line 29, sales for resale.
Authorization
Under penalties of perjury, I declare that I have examined this exemption certificate and accompany documents, and to the best of my knowledge and
belief, it is true, correct and complete.	
Authorized Purchaser (please print)

Date (mm/dd/yyyy)

Signature

Purchaser Title