R-1007 (3/19)

                                          Farm-Related Products
                                          (COMMERCIAL FARMERS ONLY)
                                          Sales Tax Exemption Certificate
                                          Louisiana Revised Statute 47:301 et seq.  

Note: In order to be considered valid, a copy of Form R-1091,          Commercial Farmer Certification, must be attached to the completed  
exemption certificate.
                                                                                                                    PLEASE PRINT OR TYPE
                                          Purchaser Information
Commercial Farm/Farmer                                                       Certification No.                      Certification Expiration Date

Physical Address                          City                                                                      State ZIP

Mailing Address                           City                                                                      State ZIP

Contact Number                            Farm Goods Produced

The purchaser named above certifies that: (Mark one or more, as applicable.)
     Sales  
X    Return                                    Exemption Description
     Code
                 The seed, fertilizers, or pesticides, including insecticides, herbicides, and fungicides purchased will be used for planting or treatment 
                 of crops grown in commercial quantities for sale, or for consumption by livestock or livestock products that are for commercial sale. 
     5016        This exemption may not be claimed by persons growing vegetables, ornamental plants, lawns, etc., for their personal use and not for 
                 commercial sale. [LA R.S. 47:301(10)(e), 47:305(D)(1)(f), 47:305.3, 47:305.8]
                 The containers purchased will be used in the packaging for sale of commercial farmer-produced farm products. The containers will be 
     5016        sold with the farm products. [LA R.S. 47:305(D)(1)(f)]
                 The  diesel  fuel,  butane,  propane,  and  other  liquefied  petroleum  gases  purchased  will  be  used  for  farm  purposes  as  a  pow-
     5067        er source or as a heating fuel for equipment that is used directly in a commercial growing or livestock production operation.  
                 [LA R.S. 47:305.37]
                 The  pharmaceuticals  must  be  registered  with  the  Louisiana  Department  of  Agriculture  and  Forestry  and  must  be 
                 administered to livestock used for agricultural purposes.  The pharmaceuticals must be administered by the commercial 
     1087        farmer who raises livestock for profit or who raises crops, animals, plant products, or animal products for commercial sale.  
                 [LA R.S. 47:301(16)(f)]
                 Feed and feed additives sold to commercial farmers for agricultural or commercial purposes. Commercial purposes means purchas-
     5003        ing, producing, or maintaining of animals, including breeding stock, for resale. The sale of feed for animals held for personal use are 
                 not exempt and is subject to state sales tax. [LA R.S. 47:305(A)(4)(a), 47:305(A)(4)(b)(i) & (iii)]
     5095        Polyroll tubing sold or used for commercial farm irrigation [LA R.S. 47:305.63]

Under penalties of perjury, I declare that I have examined this exemption certificate and to the best of my knowledge and belief, it is true, correct, 
and complete.
                                               Authorization
Commercial Farmer or Authorized Agent                                  Title

Signature                                                              Date  (mm/dd/yyyy)

                                               Caution
The seller is responsible for properly administering this sales tax exemption and the seller may be held liable for payment of the sales 
tax if the exemption certificate is improperly accepted for equipment that clearly do not qualify for exemption under the statute.
Questions about the completion of this application should be sent to   Sales.Inquiries@la.gov.