Webster Parish

Sales & Use Tax Commission
1128 Homer Road ˜ P.O. Box 357 ˜ Minden, LA 71058 ˜ Phone: (318) 377-8948 ˜ Fax: (318) 377-
4089

                APPLICATION FOR EXEMPTION CERTIFICATE

                                                                                         Account #                                         
Account Name:                                                                                Phone #                                           

Business Owner’s Name:                                                                 Owner’s SS#                                   
Mailing Address:                                                                                             Zip:                               
Nature of Business:                                                                                                                                  
Purpose of request for Exemption Certificate:                                                                                          

                                ACKNOWLEDGMENT

I,                                                                        , acting in an authorized capacity for                              
                                                         do hereby certify that the information contained herein is true and
correct to the best of my knowledge and that the certificate requested will be used solely for the
purpose(s) specified in this application. Use of the certificate for any purpose other than made known in
this application shall subject applicant to full penalties under the law of this state and local ordinances.

                                                                            Signed:                                                                    

                                                                                         Date:                                                 

***************************************************************************************************************

FOR OFFICE USE ONLY:                                                                  Received:                                                     

Request:  9Granted   9Denied                                                          Expiration Date:                                           
If denied, give reason:                                                                                                                              

9Retailer 9Manufacturer         9Other                                                          

Signed:                                                                          

INSTRUCTIONS ON PROPER USAGE OF EXEMPTION CERTIFICATES

The Webster Parish Sales & Use Tax Commission provides exemption certificates for use by
registered dealers for the purpose of acquiring tangible personal property for resale in the normal
course of business. Application for an approval is necessary prior to this office providing the
applicant with the necessary and proper certificate.

Once the exemption certificate is received, it should be filed with those vendors from whom your
resale inventory is purchased. Dealers are reminded that these exemption certificates are for
primary use through wholesale establishments. It should be noted that most retail establishments
will not accept exemption certificates. The reason for their non-acceptance is that they do not hold
themselves out as being engaged in wholesale activity.

The exemption certificate should be completed to include the vendor to whom it is being issued,
as well as covering the property purchased from said vendor which qualifies for exemption
treatment. Dealers are reminded that the exemption certificate is not by design for use to
purchase tangible personal property which will not be resold, but rather used or consumed in the
everyday operations of the business. Such purchases are taxable to the dealer and the applicable
taxes either paid to the vendor or accrued and reported under line 14 of your Webster Parish
Sales & Use Tax report. Dealers who purchase property or services that are not taxed should self-
assess themselves the tax and report it as previously advised.

Also, please note that the exemption certificate granted is valid for only a three year period. It
should be renewed at the appropriate time, by submitting a new application outlining any changes
in the business operations which could have a direct bearing on the renewal of said exemption
certificate.

The execution of this exemption certificate is very critical to the vendors to whom they are
presented. Vendors from whom you purchase tangible personal property must charge the local
tax in all instances where an exemption certificate has not been furnished. If you are engaged in
the sale of tangible personal property, and a customer wishes to make a purchase for resale, then
you should ensure that a similar exemption certificate be provided to you by the customer in order
that sufficient documentation of the non-taxable transaction is retained in your files for future
reference. Any questions that you may have concerning the exemption certificate or its proper use
should be directed to the Sales Tax Commission at (318) 377-8948