F.o.t. Application 5b/fuel Oil Tax Act/purchase Of Fuel Oil Tax Exempt For Generators Form Page 2
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210. Any exempt fuel purchased may only be used for eligible stationary electrical generators as described in the
Fuel Oil Tax Act. Fuel purchase and consumption records must be maintained in sufficient detail so that exempt and
taxable fuel can be tracked separately.
a) Is there a separate storage tank for fuel purchased for exempt use?
_____ Yes
_____ No
If Yes, what size is the tank? ____________________________________
b) Describe how you will track your exempt and taxable fuel volumes.
__________________________________________________________________________________________________
11. Fuel suppliers
(list all suppliers within Yukon as well as outside of Yukon, if applicable)
NAME
LOCATION
12. Declaration
I, _______________________________________ , _____________________________________ as a duly authorized
Print name
Print title
officer of ______________________________________________________________________________________________
Print company name
hereby certify, that the information contained in this application is correct to the best of my knowledge and belief
and hereby make application as required under the Fuel Oil Tax Act and undertake to comply with the provisions of
this Act and the Regulations thereunder.
__________________________________________________
_____________________________________________
Signature
Date
__________________________________________________
_____________________________________________
Signature
Date
For inquiries call Taxation at (867) 667-5345
Submit this application via:
Mail:
Government of Yukon
or
Email: yk.taxreturns@gov.yk.ca
Department of Finance, Taxation
or
Fax:
(867) 456-6709
Box 2703, Whitehorse,
Yukon, Y1A 2C6
The personal information requested on this form is collected under the authority of and used for the purpose of administering the Fuel Oil Tax Act.
Questions about the collection or use of this information can be directed to the Yukon Department of Finance, Box 2703, Whitehorse, Yukon, Y1A
2C6, (867) 667-5343.
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