Form Ppt-6-B - Application For Direct Payment Permit
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2PPT-6-B
STATE OF NEW JERSEY
(10-99)
DIVISION OF TAXATION
PETROLEUM PRODUCTS GROSS RECEIPTS TAX
Application Required by
NJ Motor Fuel Tax Law
PO BOX 189
TRENTON, NEW JERSEY 08695-0189
APPLICATION FOR DIRECT PAYMENT PERMIT
General Information
A Direct Payment Permit, Form PPT-6, is evidence that the buyer designated thereon is authorized to issue a Direct
Payment Certificate, Form PPT-6A, in certain cases, in lieu of payment of the Petroleum Products Gross Receipts Tax at the
time of purchase, and subsequently to file reports and remit the tax directly to the Director.
When the purchaser who has issued the Direct Payment Certificate in turn makes a sale of petroleum products
delivered to a location in New Jersey and sells to a buyer which is not a distributor or the holder of a Direct Payment Permit,
the consideration from such sale results in gross receipts subject to tax unless the sale otherwise qualifies for exemption,
exclusion, or deduction. Such seller must report and remit the tax to the Director.
Taxpayers who could qualify for the Direct Payment Authority include (a) those selling No. 2 fuel for residential heating
purposes, (b) those selling propane for residential heating purposes, and (c) blenders of petroleum products where the final
product is a petroleum product.
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1. FID #
OR Soc. Sec. # of Owner
2. Name ________________________________________________________________________________________________________________
(IF INCORPORATED - give Corp. Name; IF NOT - give Last name, First Name, MI of Owner(s))
3. Trade Name ___________________________________________________________________________________________________________
5. Mailing Name and Address - (if different from business address)
4. Business Location:
Street _____________________________________________________
Name________________________________________________
City_________________________________________ State
Street________________________________________________
-
Zip Code
City____________________________________ State
(Give 9-digit Zip)
-
Zip Code
(Give 9-digit Zip)
6. Beginning date for this business in New Jersey
__________ / __________ / __________
Month
Day
Year
7. Type of Ownership (check one):
¨
¨
¨
¨
¨
NJ Corporation
Sole Proprietor
Partnership
Out-of-State Corporation
Limited Partnership
¨
Other - explain _________________________________________________________________________________________________________
8. Telephone Numbers: Contact Person ______________________________________________
Title _____________________________________
Daytime: (
) _________ - _________________Ext___________
Evening: (
) _________ - _________________Ext__________
9. IF A CORPORATION, complete the following:
Date of Incorporation
__________ / __________ / __________
State of Incorporation
Month
Day
Year
10. Provide the following information for ALL owners, partners or responsible corporate officers. (If more space is needed, attach rider).
NAME
HOME ADDRESS
%
SOCIAL SECURITY NUMBER
OWNED
(Last Name, First, M.I.)
TITLE
(Street, City, Zip)
NOTE:
On a separate sheet of paper provide the name of stockholders owning 10% or more of the outstanding shares of stock in the corporation.
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