R-1319 (7/18)
                                                                                             Louisiana Department of Revenue
                                  Crawfish Production or Harvesting                          Revenue Processing Center
                                  Sales Tax Exemption Certificate                            P.O. Box 4998
                           Louisiana Revised Statute 47:305(A)(5)(a) and (b)                 Baton Rouge, LA  70821-4998
                                                                                             Telephone:  (855) 307-3893

Louisiana Revised Statute 47:305(A)(5)(a) exempts the purchase or use of materials, supplies, equipment, fuel and related items other 
than vessels when used in crawfish production or harvesting. Louisiana R.S. 47:305(A)(5)(b) also provides an exemption from state sales 
tax on the purchase or use of bait and feed used in the production or harvesting of crawfish.
                                                                                                          PLEASE PRINT OR TYPE
Purchaser Name

Address                           City                                                                    State ZIP

I, the purchaser named above, hereby certifies that the following items purchased from:
Seller’s Name

Address                           City                                                                    State ZIP

are to be used exclusively in the production or harvesting of crawfish, in either private or public waters. It is further agreed and understood 
that if items purchased tax-free through the use of this certificate are used for purposes other than that stated herein, the purchaser will 
be subject to the tax, interest, and penalties provided by law.

Sales Return Code                                                   Description

        5006           Sales of bait and feed used in the production and harvesting of crawfish. (La. Rev. Stat. 47:305(A)(5)(b)).

                       Sales of materials and supplies used in the production and harvesting of crawfish. (La. Rev. Stat. 47:305(A)
        5005
                       (5)(a)). Please list: ________________________________________________

        5005           Sales of fuel used in the production and harvesting of crawfish. (La. Rev. Stat. 47:305(A)(5)(a)). 

                       Sales of equipment (other than vessels) and related items used in the production and harvesting of craw-
        5005
                       fish. (La. Rev. Stat. 47:305(A)(5)(a)). Please list: _____________________________

Notice to Dealer:  Report these sales on the appropriate sales tax return schedule using the above referenced sales tax exemp-
tion codes.

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
Signature of Purchaser                                         Date (mm/dd/yyyy)
X

                                  Caution to Seller
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 items that clearly do not qualify for exemption under the statute. Misuse of this 
exemption certificate will subject the buyer or seller to payment of the tax and all civil or criminal penalties provided for by Title 47 of the 
Louisiana Revised Statutes.
Questions about the completion of this exemption certificate should be sent to Sales.Inquiries@la.gov.