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Page 2 of 2 FT-1001 (9/11)

Instructions

Who may use this form

Specific product type

Persons registered as distributors of diesel motor fuel and retailers

Enter the specific type of product being purchased (for example,

of non-highway diesel motor fuel only may use this certificate to

non-highway diesel motor fuel). The specific product being sold to

purchase non-highway diesel motor fuel for resale without paying

a distributor of kero-jet fuel only must be kero-jet fuel and must be

the petroleum business tax, excise tax, and prepaid sales tax.

sold with the prepaid sales tax included.

Persons registered as distributors of kero-jet fuel only may use this

Blanket certificate

certificate to purchase kero-jet fuel for resale directly into aircraft

If this is a blanket certificate, the seller must determine whether the

without paying petroleum business tax and excise tax but subject

purchaser’s name appears on the list of distributors in effect at the

to prepaid sales tax.

time of any subsequent transaction. If the person’s name does not

appear, the seller is responsible for taxes on all sales made to the

Only a distributor of diesel motor fuel may sell non-highway diesel

purchaser subsequent to the date of this list or the date the seller

motor fuel or kero-jet fuel to purchasers using this certificate.

becomes aware that the person is no longer registered, whichever

Purchaser

is first.

Do not use this certificate if the diesel motor fuel is being

Definitions

purchased for your own personal use.

Diesel motor fuel is No. 1 diesel fuel, No. 2 diesel fuel, biodiesel,

Verification by the seller

kerosene, crude oil, fuel oil or other middle distillate and also motor

fuel suitable for use in the operation of an engine of the diesel type.

Before accepting this certificate the seller must use

It does not include any product specifically designated as No. 4

Publication 532, New York State Registered Distributors of

diesel fuel.

Petroleum Business Tax Fuels and Licensed Importing Transporters

and Terminal Operators, to verify that the purchaser is registered

Non-highway diesel motor fuel is any diesel motor fuel that is

as:

designated for use other than on a public highway (except for the

• a distributor of diesel motor fuel or retailer of non-highway

use of the public highway by farmers to reach adjacent lands), and

diesel motor fuel only if purchasing non-highway diesel motor

is dyed diesel motor fuel.

fuel, or

Highway diesel motor fuel is any diesel motor fuel that is not

• a distributor of kero-jet fuel only if purchasing kero-jet fuel.

non-highway diesel motor fuel.

If the purchaser was registered after the publication date of the

Dyed diesel motor fuel is diesel motor fuel that has been dyed

latest Publication 532 or update, the seller may instead receive

in accordance with and for the purpose of complying with the

a copy of the purchaser’s registration dated after the publication

provisions of 26 USC 4082(a).

date of the latest Publication 532 or update.

Need help?

If upon receiving Form FT-1001, the seller does not verify that

the purchaser is properly registered, the seller has not accepted

Form FT-1001 in good faith and may be jointly and severally liable

Visit our Web site at

for the taxes.

• get information and manage your taxes online

Seller

• check for new online services and features

You are required by law to provide the purchaser with proper

certification of either tax paid or tax exemption, as applicable.

Telephone assistance

If box 1 is marked, provide a completed Form FT-1000-A,

Certification of Exclusion of Sales, Diesel Motor Fuel, and

Miscellaneous Tax Information Center: (518) 457-5735

Petroleum Business Taxes from Selling Price. If box 2 is marked,

To order forms and publications:

(518) 457-5431

provide a completed Form FT-1000, Certificate of Prepayment or

Payment of Taxes on Diesel Motor Fuel. You may use an invoice or

other billing document instead of Form FT-1000 or Form FT-1000-A

Text Telephone (TTY) Hotline (for persons with hearing

provided the document contains the following information:

and speech disabilities using a TTY): If you have

• date of sale,

access to a TTY, contact us at (518) 485-5082.

If you do not own a TTY, check with independent

• your name and address,

living centers or community action programs to find

• your sales tax identification number and motor fuel registration

out where machines are available for public use.

number (if any), or diesel motor fuel registration number,

• purchaser’s name and address,

Persons with disabilities: In compliance with the

Americans with Disabilities Act, we will ensure

• number of gallons of each type of fuel delivered,

that our lobbies, offices, meeting rooms, and other

• date of delivery and the respective invoice or other billing or

facilities are accessible to persons with disabilities. If

shipping document numbers,

you have questions about special accommodations

• separately stated amount per gallon for each tax (diesel motor

for persons with disabilities, call the information

fuel tax, petroleum business tax, and prepaid sales tax) included

center.

in the selling price, and

• a statement that the amounts of tax shown have been or will be

paid by you or your supplier.

A distributor of kero-jet fuel only may use this certificate for the

purchase of kero-jet fuel.

Form Ft-1001 - Exemption Certificate For Diesel Motor Fuel Interdistributor Transactions Page 2

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