Form Pt -102.1 - Diesel Motor Fuel Receipts And Nontaxable Sales

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New York State Department of Taxation and Finance
PT-102.1
(3/01)
Diesel Motor Fuel
Receipts and Nontaxable Sales
Read instructions (Form PT-102-I) carefully. Keep a copy of this completed form for your records.
Name of distributor
FEIN
Month/year
Part I – Receipts in New York State from sources outside this state
Seller’s
Product
Date
Gallons
type*
Name
Address
FEIN
(city and state/province)
Total gallons
......................................................................................
(enter here and on Form PT-102, line 2)
Part II – Receipts in New York State from sources within this state
Seller’s
B
A
Gallons purchased
Product
on which the taxes
All other gallons
Date
Name
FEIN
type*
have been passed
through to you
Totals ...........................................................................................................................
Total gallons
.............................................
(add columns A and B totals; enter here and on Form PT-102, line 3)
Part III – Sales of unenhanced diesel product to persons registered under
Article 12-A/13-A for diesel motor fuel
Purchaser’s
Gallons
Date
Name
FEIN
Total gallons
(enter here and on Form PT-102, line 16) .......................................................................................................................
*Product type: 1 - Kerosene; 2 - No. 2 fuel oil; 3 - Diesel fuel, No. 1 diesel fuel, No. 2 diesel fuel, and enhanced No. 2 fuel oil;
4 - No. 4 fuel oil; 5 - Kero-jet fuel; 6 - Other.

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