The undersigned is an authorized principal in ___________, is licensed by the Louisiana Board of Contractors as required by R.S. 47:6030, and certifies under penalty of law, particularly R.S. 14:202.2(A), that the system sold or leased to the homeowner of the residence located at _____________ has a total nameplate value of ________ kilowatts, that no solar dealer, solar installer, or installer affiliate financed the repayment obligations, and that a reasonable good faith belief exists that the residence is eligible for the credit provided for in this Section in the amount claimed on a Louisiana income tax return.
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Dealer's Name (printed) Dealer's Name (signature)
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Dealer's Louisiana License Number
The undersigned is an authorized principal in ___________, is licensed by the Louisiana Board of Contractors as required by R.S. 47:6030, is a licensed installer, as required by R.S. 37:2156.3, and certifies under penalty of law, particularly R.S. 14:202.2(A), that the system installed at the residence located at _____________ has a total nameplate value of ________ kilowatts.
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Installer's Name (printed) Installer's Name (signature)
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Installer's Louisiana License Number
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Date the installation of the energy system was completed and placed in service
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Notary Public
La. Revenue and Taxation § 47:6030