Blanket Certificate of Exemption Covering
Purchases for Resale or for Further Processing Under the
                                         Livingston Parish Public Schools
                                         Sales and Use Tax Ordinances

Date:________________________

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

_________________________________        ______________________________________
                  Seller’s Business Name            Seller’s Address

are to be used for resale or further processing and are, therefore, exempt from the provisions
of Livingston Parish Public Schools Sales and Use Tax Ordinances.

_________________________________        ______________________________________
                 Purchaser’s Business Name Purchaser’s Address

_________________________________            ______________________________________
            Nature of Purchaser’s Business       Describe Products Sold/Leased/Rented

                ___________________________________________________
                             Livingston Parish Sales Tax Registration Number

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

____________________________________       ______________________________
                    Signature of Purchaser                                                                  Title of Purchaser

Any Purchaser who fraudulently signs this certificate without intent to use the
property or services purchased as stated above shall be subject to all penalties provided for by
Livingston Parish Public Schools Sales and Use Tax Ordinances.

*This form may be reproduced             . *This form is valid only if all information is complete.

*The seller must retain this form.

***This Certificate Expires One Year from Date Signed***