Form Pt-303 - Railroad Exemption Certificate For Non-Highway Diesel Motor Fuel printable pdf download

PT-303

New York State Department of Taxation and Finance

Railroad Exemption Certificate for

(9/11)

Non-Highway Diesel Motor Fuel

Purchasers and sellers: Read instructions and certification carefully before giving or accepting this certificate.

Sellers: Your sales are subject to the petroleum business tax at the highway diesel motor fuel rate, unless the purchaser gives you a

properly completed certificate at or before the time of delivery. Keep this certificate for at least three years.

Purchasers: You must complete this certificate and give it to the seller. Please type or print.

Name of seller

Name of purchaser

Street address

City

State

ZIP code

City

State

ZIP code

New York State diesel motor fuel registration number

Purchaser’s Certificate of Authority number

Mark an X in the applicable box:

Single-purchase certificate

Date of delivery

Invoice or delivery ticket number

Gallons purchased or sold

Blanket certificate — will be considered part of any order given to the seller and will remain in force until revoked by written notice.

I, the undersigned, do hereby certify that the non-highway diesel motor fuel covered by this certificate will be used only to fuel locomotives

or other self-propelled rolling stock that runs only on rails. The fuel is being delivered into a storage tank not equipped with a nozzle

designed to fuel a motor vehicle or delivered directly into locomotives or other self-propelled rolling stock that runs only on rails. (My

purchase of non-highway diesel motor fuel is subject to the petroleum business tax at the railroad diesel rate and, exempt from the

diesel motor fuel excise tax and state and local sales taxes.)

I hereby certify that the non-highway diesel motor fuel being purchased will be delivered and used as stated above.

Signature of purchaser or authorized representative

Title

Date

Any person who attempts to use this form to evade taxes due on diesel motor fuel will be subject to penalties as provided by the New York

State Tax Law. Under section 1812-f(1), this person shall be guilty of a misdemeanor; however, if the tax liability evaded is equal to or greater

than $1,000, such person would be guilty of a class E felony.

General information

sales until revoked in writing by the purchaser, or the purchaser

may mark the single-purchase certificate box, in which case a

A person may purchase non-highway diesel motor fuel at the

separate certificate must be given for each subsequent sale.

railroad diesel rate by giving this properly completed certificate to a

registered distributor of diesel motor fuel. All the fuel must be used

The purchaser or an authorized representative of the purchaser

only to fuel locomotives or other self-propelled rolling stock that

must sign this certificate.

runs only on rails. The seller must deliver the non-highway diesel

motor fuel directly into the locomotives or other self-propelled

Need help?

rolling stock. If the seller delivers the non-highway diesel motor fuel

into a storage tank, the tank must not be equipped to fuel motor

Internet access:

vehicles.

(for information, forms, and publications)

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

Telephone assistance

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

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

is dyed diesel motor fuel.

Miscellaneous Tax Information Center:

(518) 457-5735

To order forms and publications:

(518) 457-5431

The distributor must keep this certificate for at least three years

after the date of the last sale covered by the certificate.

Text Telephone (TTY) Hotline (for persons with

hearing and speech disabilities using a TTY):

(518) 485-5082

Instructions

Persons with disabilities: In compliance with the

The purchaser must give this certificate to the seller at or before

Americans with Disabilities Act, we will ensure that our

the first sale of non-highway diesel motor fuel covered by this

lobbies, offices, meeting rooms, and other facilities are

certificate.

accessible to persons with disabilities. If you have questions

The purchaser may mark an X in either the blanket certificate box,

about special accommodations for persons with disabilities, call

in which case this certificate may be used to cover all subsequent

the information center.

Form Pt-303 - Railroad Exemption Certificate For Non-Highway Diesel Motor Fuel

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