Form R-5606 - Certificate Of Tax-Free Sales To The U.s. Armed Forces

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R-5606 (8/11)
Louisiana Department of Revenue
Certificate of Tax-Free Sales to the U.S. Armed Forces
Special Programs Division
Excise Taxes Section
P. O. Box 201
Baton Rouge, LA 70821-0201
Mark one.
■
■
Alcoholic Beverage
Beer
Tobacco
PLEASE PRINT OR TYPE.
Date
(mm/dd/yyyy)
No. of containers
Size of each
Total no. of pkgs.
Name or Brand of Merchandise
or pkgs. per case
pkg. or container
or containers
Seller’s Certification
This is to certify that the merchandise listed above was sold to the U.S. Armed Forces as follows:
Invoice Number
Invoice Number Date
(mm/dd/yyyy)
Sold by (Louisiana Wholesale Dealer)
Seller’s Address
City
State
ZIP
Seller’s Signature
Title
Buyer’s Certification
Sold to (name)
Title
Name of Installation
Post, Camp, or Station
City
State
ZIP
This is to certify that the commodities listed above were purchased with U.S. Government controlled funds and were received by the
indicated military installation for resale to military personnel only.
Buyer’s signature

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