BLANKET CERTIFICATE OF EXEMPTION COVERING
      PURCHASES FOR RESALE OR FOR FURTHER PROCESSING UNDER THE
      CITY OF BATON ROUGE AND PARISH OF EAST BATON ROUGE
                       SALES AND USE TAX ORDINANCES

DATE:                                                     , 20           

This certifies that all materials, goods, merchandise and services purchased by the undersigned from

are to be used for resale or further processing and are, therefore, exempt from the provisions of the City of
Baton Rouge and Parish of East Baton Rouge Sales and Use Tax Ordinances.

                       Purchaser’s Business Name 

                       Sales Tax Registration Certificate Number

The undersigned purchaser further agrees that should the sale to him be later held subject to tax, he
assumes full liability.

                                                            Signature of Purchaser

                                                              Address

Any purchaser who fraudulently signs this Certificate without intent to use the property or
services purchased as above stated shall be subject to all penalties provided for by City of Baton
Rouge and Parish of East Baton Rouge Sales and Use Tax Ordinances.