Form Ga-It - Estimated Tax Return And Application For Extension Of Time To File New Jersey Motor Fuels Tax Return

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Form GA-IT
(07-04)
STATE OF NEW JERSEY
DIVISION OF TAXATION
ESTIMATED TAX RETURN AND APPLICATION FOR EXTENSION OF TIME TO FILE
NEW JERSEY MOTOR FUELS TAX RETURN
(N.J.S.A. 54:39-1 et seq.)
TAXABLE PERIOD
MONTH
YEAR
FID#
SEE INSTRUCTIONS
NAME
LICENSE NO:
ADDRESS
DISTRIBUTOR
GASOLINE JOBBER
IMPORTER
SELLER / USER
CITY
STATE
ZIP
Application is hereby made for the above licensee for an extension for filing the completed return by the
last business day of the month.
Warning
Remittance to cover the full amount of estimated tax as per computation below must accompany this application.
No extension will be granted in the absence of such remittance. Penalties are assessed, for underestimation of tax.
COMPUTATION OF ESTIMATED TAX
1.
Amount of N. J. Motor Fuels Tax paid for same period last year .............
2.
Estimated Tax Liability for taxable period indicated above ......................
3.
Amount of Tax remitted with this estimated return ...................................
Make remittance payable to “State of New Jersey – Motor Fuels Tax” and forward with this return to Division of
th
Taxation, PO Box 243, Trenton, NJ 08646 on or before the 20
of the month following the report month.
Signature and Verification
I declare under the penalties provided by law, that this return (including any accompanying Schedules and
statements) has been examined by me and to the best of my knowledge and belief is a true, correct and complete
return. If the return is prepared by a person other than the taxpayer, his declaration is based on all the information
relating to the matters required to be reported in the return of which he has knowledge.
(Date)
(Signature of Authorized Officer of Taxpayer)
(Title)
(Date)
(Signature of Individual Preparing Return)
(Address)
(Title)
(Date)
(Name of Tax Preparers Employer)
(Address)
(Title)
FOR DIVISION USE ONLY DO NOT WRITE BELOW THIS LINE
THIS FORM MAY BE REPRODUCED

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