Form Tp-115 - Application For Registration As An Aviation Fuel Business Or As A Residual Petroleum Product Business
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4TP-115 (9/95)
New York State Department of Taxation and Finance
Application for Registration as an Aviation Fuel Business
or as a Residual Petroleum Product Business
Read instructions carefully. Attach additional sheets as necessary to fully answer all questions.
Check the appropriate box to show type of registration (see instructions for definitions) :
Aviation fuel business - airline
Aviation fuel business - nonairline
Residual petroleum product business
Request for transfer of registration as
Request for transfer of registration as an
Request for transfer of registration
an aviation fuel business - airline
aviation fuel business - nonairline
as a residual petroleum product
business
Department use only
Print or type
1 Legal name
2 Trade name
(if different from item 1)
3 Address of principal place of business
City
State
ZIP code
(number and street)
4 Mailing address
(if different from business address)
5 County (
6 Telephone
7 Date business began or will begin in New York State
principal place of business)
(include area code)
(
)
8 Federal employer identification number
9 Other federal employer identification number, if any
10 Type of organization
(check one or more boxes)
Individual
Partnership
Corporation
LLC
LLP
Other
(specify)
11 Activities
:
(check any boxes that apply)
Importing kero-jet fuel into New York State in fuel
tanks of aircraft
Importing or causing to import residual petroleum product into New
York State for use, distribution, storage or sale in New York State
Supplying passenger or cargo air carrier services
Producing, refining, manufacturing or compounding residual
to others
petroleum product within New York State
Selling residual petroleum product in New York State
Other
(specify)
12 List owners, directors, partners and responsible individuals
. Attach additional sheets if necessary.
(see instructions)
Name
Social security number
Percentage of ownership
Home address
Title
City
State
ZIP code
Duties (a-g) (See instructions)
Telephone number
(
)
Name
Social security number
Percentage of ownership
Home address
Title
City
State
ZIP code
Duties (a-g) (See instructions)
Telephone number
(
)
Name
Social security number
Percentage of ownership
Home address
Title
City
State
ZIP code
Duties (a-g) (See instructions)
Telephone number
(
)
13 Enter the percentage of voting stock held by all other owners. Total percentage of voting stock in items 12 and 13 must
%
equal 100% ......................................................................................................................................................................................
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