Form St-130 - Business Purchaser'S Report Of Sales And Use Tax - 2010

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ST-130
New York State Department of Taxation and Finance
Business Purchaser’s Report of Sales and Use Tax
(11/10)
This form is for use only by New York State businesses not registered or required to be registered for sales tax purposes. Do not
use this form to report sales and use taxes due: (1) on business purchases if the business is registered, or required to be registered,
for sales tax purposes; (2) on nonbusiness purchases; or (3) on the purchase of a motor vehicle, trailer, all-terrain vehicle, vessel, or
snowmobile that must be registered or titled by the New York State Department of Motor Vehicles. See instructions.
For Tax Department use only
Type or print clearly
Location code
Purchaser’s name
Federal identification number
Tax jurisdiction code
Purchaser’s address
(number and street or rural route)
Taxable sales
City
County
State
ZIP code
Sales and use tax
1a
Date item(s) or service(s) was first brought into New York State
(see instructions)
1b
Seller’s name
Address
City
State
2
Location of delivery or use, if different from purchaser’s address above
(see instructions)
Number and street or rural route
City
County
3
3
Amount subject to sales or use tax
....................................................................
(see instructions)
4
%
4
Tax rate
..............................................................................................................
(see instructions)
5
5
Tax due
..........................................................................
(multiply amount on line 3 by rate on line 4)
6
6
Allowable credit for tax paid (if any) to another jurisdiction
................................
(see instructions)
7
7
Total New York State sales or use taxes due
........................................
(subtract line 6 from line 5)
8
8
Penalty and interest if you are filing or paying late
............................................
(see instructions)
9
9
Total amount due
Attach check or money order payable to: New York State Sales Tax ....
(add lines 7 and 8).
Certification: I certify that the above statements are true and correct. I make these statements with the knowledge that knowingly
making a false or fraudulent statement on this document is a misdemeanor under section 1817 of the Tax Law and a Class E felony
under section 175.35 of the Penal Law, punishable by imprisonment for up to four years and a fine of up to $50,000 for an individual
or $250,000 for a corporation. I understand that the Tax Department is authorized to investigate the validity and accuracy of any
information entered on this form.
Signature of purchaser or purchaser’s representative
Date
Telephone number for purchaser
(give title and relationship)
(
)
Printed name of preparer
(if other than purchaser)
Preparer’s address
Preparer’s signature
Preparer’s telephone number
(if other than purchaser)
(
)
For Tax Department use only
Mail this report and remittance to:
NYS TAX DEPARTMENT
SALES TAX DESK AUDIT — CASUAL SALES UNIT
W A HARRIMAN CAMPUS
ALBANY NY 12227

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