Form R-1397 "Purchases of Electricity for Use by a Stripper Well - Sales Tax Exemption Certificate" - Louisiana

What Is Form R-1397?

This is a legal form that was released by the Louisiana Department of Revenue - a government authority operating within Louisiana. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2018;
  • The latest edition provided by the Louisiana Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form R-1397 by clicking the link below or browse more documents and templates provided by the Louisiana Department of Revenue.

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Download Form R-1397 "Purchases of Electricity for Use by a Stripper Well - Sales Tax Exemption Certificate" - Louisiana

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R-1397 (12/18)
Purchases of Electricity for Use by a Stripper Well
Sales Tax Exemption Certificate
Louisiana Revised Statute 47:305(D)(1)(d)
PLEASE PRINT OR TYPE
Purchaser Information
Louisiana Tax Account Number
Company Name
Address
City
State
ZIP
Well Information
911 Physical Address
City
State
ZIP
Office of Conservation Codes
Field
Lease
Well Serial No.
Parish
Producer
Purchaser
Act 1 of the 2018 Third Extraordinary Session provides a sales tax exemption for the sale and purchase of electricity as provided in Lou-
isiana Revised Statute 47:305(D)(1)(d) for use in production activity subject to the payment of state severance tax on production from a
stripper well pursuant to Louisiana Revised Statute 47:633(7)(c)(i) and (ii)(aa) and (bb). This exemption certificate will not be considered
complete, unless all of the information is included on this form.
I, the purchaser named above, do hereby certify that electricity purchased from the seller named below is used in the production of oil
subject to the payment of state severance tax on production from a stripper well pursuant to Louisiana Revised Statute 47:633(7)(c)(i) and
(ii)(aa) and (bb).
The purchaser further agrees that any electricity purchased under this exemption certificate and not used by a stripper well certified by
the Louisiana Department of Revenue (LDR) will be deemed taxable and the purchaser will accrue and remit sales tax at the current rate
to LDR.
Any purchaser who fraudulently signs this certificate without intent to use the electricity purchased as stated above shall be subject to all
penalties provided for by law.
Notice to Dealer: Report this sale under exemption code 5106.
Seller Information
Seller’s Name
Seller’s Account No. or Meter No.
Address
(Street & number or P.O. Box)
City
State
ZIP
Under penalty of perjury, I declare that I have examined this form and accompanying documents, and to the best of my knowledge and belief, it is true,
correct, and complete.
Authorization
Name
Title
Signature
Date
(mm/dd/yyyy)
Questions about the completion of this form should be sent to
Sales.Inquiries@la.gov.
R-1397 (12/18)
Purchases of Electricity for Use by a Stripper Well
Sales Tax Exemption Certificate
Louisiana Revised Statute 47:305(D)(1)(d)
PLEASE PRINT OR TYPE
Purchaser Information
Louisiana Tax Account Number
Company Name
Address
City
State
ZIP
Well Information
911 Physical Address
City
State
ZIP
Office of Conservation Codes
Field
Lease
Well Serial No.
Parish
Producer
Purchaser
Act 1 of the 2018 Third Extraordinary Session provides a sales tax exemption for the sale and purchase of electricity as provided in Lou-
isiana Revised Statute 47:305(D)(1)(d) for use in production activity subject to the payment of state severance tax on production from a
stripper well pursuant to Louisiana Revised Statute 47:633(7)(c)(i) and (ii)(aa) and (bb). This exemption certificate will not be considered
complete, unless all of the information is included on this form.
I, the purchaser named above, do hereby certify that electricity purchased from the seller named below is used in the production of oil
subject to the payment of state severance tax on production from a stripper well pursuant to Louisiana Revised Statute 47:633(7)(c)(i) and
(ii)(aa) and (bb).
The purchaser further agrees that any electricity purchased under this exemption certificate and not used by a stripper well certified by
the Louisiana Department of Revenue (LDR) will be deemed taxable and the purchaser will accrue and remit sales tax at the current rate
to LDR.
Any purchaser who fraudulently signs this certificate without intent to use the electricity purchased as stated above shall be subject to all
penalties provided for by law.
Notice to Dealer: Report this sale under exemption code 5106.
Seller Information
Seller’s Name
Seller’s Account No. or Meter No.
Address
(Street & number or P.O. Box)
City
State
ZIP
Under penalty of perjury, I declare that I have examined this form and accompanying documents, and to the best of my knowledge and belief, it is true,
correct, and complete.
Authorization
Name
Title
Signature
Date
(mm/dd/yyyy)
Questions about the completion of this form should be sent to
Sales.Inquiries@la.gov.