Form Pt-101.3 - Nontaxable Sales Of Motor Fuel

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PT-101.3
New York State Department of Taxation and Finance
Nontaxable Sales of Motor Fuel
(9/06)
Read instructions (Form PT-101-I) carefully. Keep a copy of this completed form for your records.
Name of distributor
FEIN
Month/year
Part 1 — Sales
to the United States government and to New York State and its municipalities
Date
Mode of
Carrier’s name
Governmental agency name
Origin
Destination
Contract or
Gallons
Product
sold
delivery
and FEIN
and FEIN
TCN or
TCN or
approval number
code*
(city, state)
(city, state)
Total gallons
........................................................................................................................................................................
(enter here and on Form PT‑101, line 14)
Part 2 — Exempt sales
on Indian reservations
(include sales to exempt Indian nations or tribes and qualified Indian consumers; see instructions)
Date
Mode of
Carrier’s name
Purchaser’s name
Origin
Destination
Manifest
Gallons
Product
sold
delivery
and FEIN
and FEIN
TCN or
TCN or
number
code*
(city, state)
(city, state)
Total gallons
........................................................................................................................................................................
(enter here and on Form PT‑101, line 15)
Part 3 — Sales to exempt diplomats and missions by credit card
Date
Dealer’s name
Purchaser’s name
Purchase location
Credit card or
Gallons
Product
sold
and FEIN
and FEIN
exempt number
code*
(city, state)
Total gallons
........................................................................................................................................................................
(enter here and on Form PT‑101, line 16)
*From Publication 902, Product Codes for Fuels.

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