R-1344 (12/02)                                       State of Louisiana
                                                     Department of Revenue

                                   Exemption Certificate
                  covering purchases of tangible personal property for rent or lease, other than motor vehicles,
                                   under Louisiana Revised Statute 47:301(10)

This certifies that the tangible personal property purchased from____________________________________________________________
                                                                             Seller/vendor
is to be offered for rent or lease in an arm’s length transaction. This also certifies that the gross proceeds received from the rent or lease of
the property will be subject to all applicable rental tax that must be remitted. It is understood that any use of the property for purposes other
than rent or lease in an arm’s length transaction will subject the property to a sales/use tax liability on its cost or fair market value at the time
of such other use.

Type of property purchased for rent or lease ____________________________________________________________________________

______________________________________________________ ____________________________________________________
                  Purchaser                                                  Signature of authorized agent

______________________________________________________ ____________________________________________________
                  Address                                                    Title

______________________________________________________ ____________________________________________________
                  City, State, ZIP                                           Date

______________________________________________________ ____________________________________________________
                  Louisiana sales tax account number                         Parish sales tax account number