Form R-1318 - Application For Advance Sales Tax Exemption "W" Number - Louisiana Department Of Revenue And Taxation Page 3

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State of Louisiana
R-1318 (9/96)
Department of Revenue and Taxation
Sales Tax Division
P.O. Box 3863
Baton Rouge, LA 70821-3863
(504) 925-7356
(504) 925-7533 (TDD)
Application for Advance Sales Tax Exemption “W” Number
Please print or type.
1. Owner name
_______________________________________________________________________________
2. Trade name
_______________________________________________________________________________
3. Mailing address _______________________________________________________________________________
_______________________________________________________________________________
4. Location address _______________________________________________________________________________
5. Louisiana Sales Tax Account Number ______________________________________________________________
6. Complete description of business, including major product lines and type of customers.
(Attach additional pages if necessary.)
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
7. Total sales at this location for the most current
$ _______________________
/
/
three-month period ending _________________
a. Percentage of total sales derived from sales of tangible personal property
_______________________
b. Percentage of total sales derived from sales of services
_______________________
(leases/rentals, repairs, etc.)
Please complete either Item 8 or 9 below, categorizing the sales shown on Line 7.
8. Types of property sold:
a. Vehicles ................................................................................................................... $ _______________________
b. Lumber .................................................................................................................... $ _______________________
c. Farm implements ....................................................................................................$ _______________________
d. Motorized earth-moving and construction equipment ............................................. $ _______________________
e. Total ........................................................................................................................$ _______________________
9. Types of customers and transactions:
a. Sales to contractors ................................................................................................. $ _______________________
b. Sales to industrial users .......................................................................................... $ _______________________
c. Sales to other dealers for resale .............................................................................$ _______________________
d. Other taxable sales (Explain.) ______________________________
................ $ _______________________
e. Total taxable sales (Add items a, b, c, and d.) .................................................... $ _______________________
f.
Sales to registered wholesalers .............................................................................. $ _______________________
g. Amount sold in interstate commerce ....................................................................... $ _______________________
h. Amount sold for first and exclusive use offshore ..................................................... $ _______________________
i.
Other exempt sales (Explain.) ______________________________
................ $ _______________________
j.
Total exempt sales (Add items f, g, h, and i.) ..................................................... $ _______________________
k. Total sales (Add items e and j.) ............................................................................... $ _______________________
Lines 8e or 9k should equal total income on Line 7.
Under the penalties of perjury, I declare that I have examined this application, including all accompanying documents, and to
the best of my knowledge and belief, it is true, correct, and complete.
Signature of applicant
Title
Signature of applicant
Title
(
)
Telephone

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