R-1334 (5/14)

                                              Commercial Fishermen                          Louisiana Department of Revenue
                                 louisiana sales Tax Exemption application                  P.O. Box 4998
                                                                                            Baton Rouge, LA 70821-4998
                                           Louisiana R.S. 47:305.20                         Telephone: 225.219.7462 • (TDD): 225.219.2114

NOTE: A separate application must be submitted for each vessel for which exemption is requested.

This application must be accompanied by copies of a current vessel license, proof of vessel ownership, commercial fishing license, and 
a complete copy of the most current federal income tax return. Proof of vessel ownership may be a copy of the boat registration, or a 
copy of the U.S. Coast Guard documentation. The vessel license, owner of vessel, fishing license, and federal income tax return must 
be in the same individual or corporation name.
                                                                                                               PlEasE PriNT Or TyPE.
 Social Security Number (Federal ID Number if a corporation)           Vessel registration/document number     Issued by: 
                                                                                                                W & F                                                     U.S.C.G.
 Name                                                                  Name of vessel

 Mailing Address                                                       Louisiana vessel license number                                                               Year

 City                                      State             ZIP       Telephone 
                                                                       (         )

I, a commercial fisherman, do hereby apply for a certificate of exemption from Louisiana state sales and use taxes under Louisiana 
Revised Statute 47:305.20 and make the following statements:

 Louisiana Resident Since (yyyy)                                       Most Recent Income Tax Year

 Total Income  
 (include wages, salaries tips & net income from sale-employment). For corporations, use total net income.  ..............

 Commercial Fishing Income ..........................................................................................................................................

I certify that my catch is for human consumption. I further certify that the vessel listed above is used primarily and principally for 
commercial fishing. I understand that exemption from state sales taxes is valid only as long as I am a commercial fisherman and meet 
all of the requirements for the exemption.
I understand that if I knowingly use this certificate for a purpose other than that authorized by R.S. 47:305.20, I may be subject to a fine 
of not less than $100 per offense, nor more than $1,000 per offense, and imprisonment without hard labor for not less than one day, nor 
more than three months.
I understand that the exemption certificate issued by the Louisiana Department of Revenue may not be transferred to any other owner 
or person.

________________________________________________    ________________________________________________
                                 Signature                                                             Date

Sworn to and subscribed before me this ______________            day of _________________________________________  _______ 
                                                                                                                                                                         Year

                                                                        ________________________________________________
                                                                                                  Notary Public

Questions about the completion of this application should be sent to Sales.Inquiries@la.gov.