Form Ppt-6-A - Direct Payment Certificate
Download a blank fillable Form Ppt-6-A - Direct Payment Certificate in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Ppt-6-A - Direct Payment Certificate with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2PPT-6-A (11-90)
STATE OF NEW JERSEY
DIVISION OF TAXATION
PETROLEUM PRODUCTS GROSS RECEIPTS TAX
P.O. Box 243
Trenton, NJ 08646-0243
DIRECT PAYMENT CERTIFICATE
Name of Buyer
Employer Identification Number
BUYER INFORMATION
______________________________________________________________________________________________
Address (number and street or rural route)
DP - ________________
______________________________________________________________________________________________
City
State
Zip Code
This certificate covers transactions beginning _____________________
CERTIFICATION OF BUYER
The undersigned certifies that:
1.
The issuer of this certificate is registered with the New Jersey Division of Taxation, holds a valid Direct Payment
Permit, and is authorized to file reports and remit the applicable Petroleum Products Gross Receipts Tax directly
to the New Jersey Division of Taxation.
2.
The issuer of this certificate is principally engaged in the following (indicate nature of business)
3.
The petroleum products being purchased are described as follows:_____________________________________
4.
I agree to make my books and records available to the New Jersey Division of Taxation for audit so that it may
verify that the sales, use, and/or consumption of the petroleum products purchased are properly reported.
5.
I, the undersigned purchaser, have read and complied with the instructions and rules promulgated pursuant to the
New Jersey Petroleum Products Gross Receipts Tax Act with respect to the use of the Direct Payment
Certificate, and it is my belief that the seller named herein is not required to pay or remit the Petroleum Products
Gross Receipts Tax on receipts from the transaction or transactions covered by this Certificate. The undersigned
purchaser hereby swears (under penalties for perjury and false swearing) that all of the information shown on this
Certificate is true.
__________________________________________________________________________________________
Signature of buyer
Title
Date
A COPY OF THE BUYER’S DIRECT PAYMENT PERMIT MUST BE ATTACHED
Name of Seller
______________________________________________________________________________________________
Address (number and street or rural route)
SELLER INFORMATION
______________________________________________________________________________________________
City
State
Zip Code
FORM MAY BE REPRODUCED
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial