Form St-140 - Individual Purchaser'S Annual Report Of Sales And Use Tax (2005) (Page 4 of 4) in pdf

Form St-140 - Individual Purchaser'S Annual Report Of Sales And Use Tax (2005) Page 4

Page 4 of 4 ST-140 (2005)

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 section 210.45 of the Penal Law, punishable by imprisonment

for up to a year and a fine of up to $10,000 for an individual or $20,000 for a corporation. I understand that the Tax Department is authorized to

investigate the accuracy of any information entered on this form.

Purchaser’s signature

Date

Telephone number for purchaser

(

)

Printed name of preparer

(if other than purchaser)

Preparer’s address

Preparer’s signature

Preparer’s telephone number

(if other than purchaser)

(

)

Need help?

Hotline for the hearing and speech impaired:

Internet access:

If you have access to a telecommunications device for

(for information, forms, and publications)

the deaf (TDD), contact us at 1 800 634-2110. If you do

not own a TDD, check with independent living centers or

community action programs to find out where machines

Fax-on-demand forms: Forms are

are available for public use.

available 24 hours a day,

7 days a week.

1 800 748-3676

Persons with disabilities: In compliance with the

Americans with Disabilities Act, we will ensure that

Telephone assistance is available from 8:00

A.M.

our lobbies, offices, meeting rooms, and other facilities

5:00

(eastern time), Monday through Friday.

P.M.

are accessible to persons with disabilities. If you have

To order forms and publications:

1 800 462-8100

questions about special accommodations for persons

Business Tax Information Center:

1 800 972-1233

with disabilities, please call 1 800 972-1233.

From areas outside the U.S. and

outside Canada:

(518) 485-6800

Private delivery services

If you choose, you may use a private delivery service, instead of the U.S. Postal Service, to file your return and pay tax.

However, if, at a later date, you need to establish the date you filed your return or paid your tax, you cannot use the date

recorded by a private delivery service unless you used a delivery service that has been designated by the U.S. Secretary of

the Treasury or the Commissioner of Taxation and Finance. (Currently designated delivery services are listed in Publication 55,

Designated Private Delivery Services. See Need help? above for information on ordering forms and publications.) If you have

used a designated private delivery service and need to establish the date you filed your return, contact that private delivery

service for instructions on how to obtain written proof of the date your return was given to the delivery service for delivery.

Mail this return and remittance to:

NYS TAX DEPARTMENT

SALES TAX DESK AUDIT — CASUAL SALES UNIT

W A HARRIMAN CAMPUS

ALBANY NY 12227

Form St-140 - Individual Purchaser'S Annual Report Of Sales And Use Tax (2005) Page 4

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