Form Ct-40 - Claim For Alternative Fuels Credit - New York State Department Of Taxation And Finance Page 3

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Page 3 CT-40 (8/98)
Section VI - Election to Transfer Credits - Article 9-A Taxpayers Only
Part A - Alternative Fuels Credits Received From Affiliates (see instructions)
Tax
Credit
Transferor Corporation Name
Employer ID (EIN)
Year
Received
31
32
33
34
Total credit received from affiliates
. . . . . . . . . . . . . . . . . . .
(add lines 31, 32, and 33; enter here and on line 2)
Certification of Transferor Corporation
I certify that I am an elected officer of or authorized person with respect to the transferor named above. On behalf of such corporation, I
elect to transfer to the taxpayer the amount of credit shown above.
Signature of elected officer or authorized person
Official title
Transferor corporation name
Date
Certification of Transferor Corporation
I certify that I am an elected officer of or authorized person with respect to the transferor named above. On behalf of such corporation, I
elect to transfer to the taxpayer the amount of credit shown above.
Signature of elected officer or authorized person
Official title
Transferor corporation name
Date
Certification of Transferor Corporation
I certify that I am an elected officer of or authorized person with respect to the transferor named above. On behalf of such corporation, I
elect to transfer to the taxpayer the amount of credit shown above.
Signature of elected officer or authorized person
Official title
Transferor corporation name
Date
Certification of Transferee Corporation
I certify that I am an elected officer of or authorized person with respect to the taxpayer. On behalf of such corporation, I elect to receive
from the affiliated corporation(s) named above the amount of credit shown on line 34 of this form.
Signature of elected officer or authorized person
Official title
Transferee corporation name
Date

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