Form Tmt-39 - New Account Application For Highway Use Tax (Hut) And Automotive Fuel Carrier (Afc) - State Of New York

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TMT-39
New York State Department of Taxation and Finance
New Account Application for
(4/11)
Highway Use Tax (HUT) and Automotive Fuel Carrier (AFC)
Get your credentials online in minutes at
To use OSCAR all you need is an active USDOT number and a Highway Use Tax ( HUT ) account
— Read the instructions, Form TMT-39-I, before completing this form. Incomplete and incorrectly prepared forms will not be processed.
— Use this form to establish a Highway Use Tax (HUT) account. When your account is approved, you will be instructed to obtain your HUT/AFC credentials online. You
will need Internet access.
— Do not use this form if you previously registered for HUT. Go directly to
— Fax completed form to (518) 435-8538. Please allow three business days for processing.
1. Identification
Employer identification number (EIN) Suffix, if any
Social security number
number
OR
SS
2. USDOT number 3. Business phone number
4. Email address
5. Fax number
6. Legal name
7. Doing business as (DBA) name, if different from legal name
8. Physical address
9. Mailing address
( number and street )
( if different than physical address; number and street or PO box )
City
State
ZIP code
City
State
ZIP code
Country
Country
( enter if other than United States; do not abbreviate )
( enter if other than United States; do not abbreviate )
10. Type of business ( mark an X in one box and specify if Other )
Sole proprietor
Corporation
Partnership
LLC
LLP
Other:
11. List the name, title, social security number, and address of each principal officer of a corporation, or of each partner, or member of an LLC/LLP, or owner if sole
proprietorship.
Name
Title
SSN
Number and street
City
State
ZIP code
12. Enter the location where tax and mileage records will be available for audit.
Name of custodian of records
Number and street
City
State
ZIP code
Telephone number
13.
Mark an X in the box if this form is completed by an agent or other representative.
Mark an X in the box if this form is completed by an employee who is not an officer of a corporation, partner of a partnership, or member of an LLC/LLP, or
owner if sole proprietor.
14. Enter name, address, and phone number of the person completing this form.
Name of employee
Title
Number and street
City
State
ZIP code
Telephone number
15.
Mark an X in the box if line 16 is signed by an employee who is not an officer, partner, member, or proprietor.
Mark an X in the box if line 16 is signed by an agent, service, or other representative.
If you mark either box, you must fax a Form POA-1, Power of Attorney, with this application.
16. Signature
Printed name of person signing
Title
Date signed
• Fax completed form to (518) 435-8538.
• We will not process incomplete and incorrectly prepared forms.
• Questions? Call (518) 457-5735.

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