Fillable Form A-3711-Mf - Refund Claim - Motor Fuel Tax 2000 (Page 2 of 2) in pdf

A-3711-MF (2-96, R-8)

Page 2

LIST OF PURCHASES

Read Carefully Before Listing Your Invoices

List below, in the spaces provided, your total purchases of Motor Fuel for this month from each source of supply. Attach invoices to support all purchases

listed. Invoices must be legible and must show the date of purchase, the name of claimant as the purchaser, the number of gallons purchased, the price

per gallon and the tax thereon. Invoices for the gallonage on which refund is claimed herein must be receipted by the supplier over his full signature, to

show that payment has been made.

NOTE: Incomplete invoices or invoices that show alterations or corrections WILL NOT BE ACCEPTED. Attach and include in purchases listed below

invoices for fuel purchased for use in vehicles on public highways.

Month

Purchased From

Gallons

Month

Purchased From

Gallons

Brought Forward

Carried Forward

Total Gallons Purchased this Month

The undersigned hereby declares that the statements contained herein are true and that signature has been affixed with full knowledge that any false

statement subjects the signer and the claimant to the penalties of a misdemeanor in accordance with the provisions of Title 54, Taxation, Subtitle 6, Chapter

39 of the New Jersey Revised Statutes as amended.

________________________________________________________________________________________________________________________

(Signature)

(Title)

IMPORTANT

More claims are returned to the claimant for faulty invoices than for any other reason. Insist that your supplier furnish you with invoices which meet in every

particular the requirements for invoices as outlined in Section 3 above. It will save you inconvenience and expedite the processing of your claim.

AUTOBUS OWNERS ATTENTION

Complete Form A-3710-MF

PROVISIONS OF THE LAW PERTAINING TO REFUNDS

54:39-66

Refund uses, application for refund, supporting tax paid invoices,

(2) who shall have paid the tax for such fuels hereby required to be paid, shall be

distributor procedure.

reimbursed and repaid the amount of tax so paid upon presenting to the

Commissioner an application for such reimbursement or repayment, in form

Any person

prescribed by the Commissioner, which application shall be verified by a declaration

(1) who shall use any fuels as herein defined for any of the following purposes.

of the applicant that the statements contained therein are true. Such application for

(a) [deleted by amendment]

reimbursement or repayment shall be supported by an invoice, or invoices, showing

the name and address of the person from whom purchased, the name of the

(b) autobusses while being operated over the highways of this State in those

purchaser, the date of purchase, the number of gallons purchased, the price paid per

municipalities to which the operator has paid a monthly franchise tax for the use

gallon, and an acknowledgement by the seller that payment of the cost of the fuel,

of the street therein under the provisions of 48:16-25 of the Title Public Utilities

including the tax thereon, has been made. Such invoice, or invoices, shall be legibly

and pursuant to RS 48:4-1 and 48:4-3,

written and shall be void if any corrections or erasures shall appear on the face

thereof.

The Commissioner may, in his discretion, permit a distributor entitled to a refund

(d) farm machinery,

under the provisions of this section to take credit therefor, in lieu of such refund, in

(e) aircraft,

such manner as the commissioner may require, on a report filed pursuant to section

54:39-27 of the Revised Statutes.

(f) ambulances,

54:39-67 Payment of refunds, time limit, false statements, fraudulent payments,

(g) rural free delivery carriers in the dispatch of their business,

misdemeanor.

(h) such vehicles as run only on rails or tracks, and such vehicles as run in

Upon approval by the director of such application a warrant shall be drawn upon the

substitution thereof,

State Treasurer for the amount of such claim in favor of such claimant and such warrant

shall be paid from the tax collected on motor fuel. The application for reimbursements

(i) such highway motor vehicles as are operated exclusively on private property,

and repayments shall be filed with the director on or before the last business day of the

(j) motor boats or motor vessels used exclusively for or in the propagation,

sixth month following that in which the fuels in question were purchased. [Any person

planting, preservation and gathering of oysters and clams in the tidal waters of

or the member of any firm or the officer or agent of any corporation who shall make

this State,

false statement in any application required for the reimbursement and repayment of any

taxes, or who shall collect or cause to be repaid to him or to any other person any such

(k) motor boats or motor vessels used exclusively for commercial fishing,

reimbursement or refund without being entitled to the same shall be guilty of a

(l) motor boats or motor vessels while being used for hire for fishing parties or

misdemeanor.

being used for sightseeing or excursion parties,

54:39-68 Establishing claim

(m) cleaning,

In order to establish the validity of claims filed, the claimant shall be required to

(n) fire engines and fire-fighting apparatus,

maintain and preserve for a period of at least two years such fuel consumption records

as may be prescribed by the Commissioner. The Commissioner shall have the right to

(o) stationary machinery and vehicles or implements not designed for the use of

require a claimant to furnish such additional proof of the validity of a claim as the

transporting persons or property on the public highway,

commissioner may determine, and to examine the books and records of the claimant for

(p) heating and lighting devices,

such purpose. Failure of the claimant to maintain and preserve such records, furnish

such additional proof or to accede to the demand for such examination by the

(q) fuels previously taxed under this chapter and later exported or sold for

Commissioner, or any of his representatives, shall constitute a waiver of all rights to the

exportation from the State of New Jersey to any other State or country provided,

claim or claims questioned and such subsequent claims as the commissioner may

proof satisfactory to the Commissioner of such exportations is submitted,

determine.

(r) motor boats or motor vessels used exclusively for Sea Scout Training by a duly

chartered unit of the Boy Scouts of America,

54:39-69 Separate invoices where refund claimed.

When fuel is sold to any person who shall claim to be entitled to a refund of the tax

(s) emergency vehicles used exclusively by volunteer first aid or rescue squads,

hereunder imposed, the seller of such fuel shall furnish the purchaser with an invoice,

(t) diesel fuel as used by passenger automobiles and motor vehicles of less than

or invoices, in conformity with the requirements pertaining to invoices set forth under

5,000 pounds gross weight, and

section 54:39-66 hereof.

Form A-3711-Mf - Refund Claim - Motor Fuel Tax 2000 Page 2

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