Form Dtf-406 - Claim For Highway Use Tax (Hut) Refund printable pdf download

DTF-406

New York State Department of Taxation and Finance

Claim for Highway Use Tax (HUT) Refund

(11/05)

Tax Law - Article 21, Section 513

Type or print in ink.

For ofﬁce use only

Employer identiﬁcation number

Social security number

Date

Total refund approved

Name of carrier

Audited by

Date

Street address

Approved by

Date

City, village, or post ofﬁce

State

ZIP code

Approved by

Date

A highway use tax refund must be ﬁled within four years from the due date of the tax return or within four years of any erroneous

payment. Reason for refund of highway use tax (mark an X in the box(es) that apply):

Form MT-927, Highway Use Tax (HUT) Overpayment/Credit Adjustment Notice

(Enter the refund amount on line 2 below and

enclose a copy of Form MT-927.)

Permit and sticker fees paid in error

(Explain below, complete the Refund summary below, and enclose the duplicate permits and stickers.)

Highway use tax paid in error (

Explain below, complete the Refund summary below, and enclose amended tax returns.)

Other (

Explain below, complete the Refund summary below, and enclose amended tax returns.)

Explanation for boxes, 2, 3, and 4 (attach additional sheets if necessary

)

Refund summary (attach additional sheets if necessary)

Tax period/permit number

Amount originally paid

Corrected amount

Refund claimed

1. $

Total

.............................................................................

(add the Refund claimed column amounts)

2. $

Amount from Form MT-927 .......................................................................................................

Total refund claimed

.......................................................................................

3. $

(add lines 1 and 2)

I hereby certify that the above claim is just, true, and correct, that no part thereof has been paid or will be claimed on any subsequent tax returns; and

that amount is actually due and owing. I make these statements with the knowledge that willfully issuing a document known to be false or fraudulent as to

any material matter is a felony under section 1815(b) of the Tax Law and a misdemeanor under section 210.45 of the Penal Law, punishable by a ﬁne up

to $50,000 for an individual or $250,000 for a corporation.

Date

Signature

Ofﬁcial title

Telephone number

(

)

Date

Print or type name of paid individual or ﬁrm preparing this return

Signature of individual preparing this return

Paid preparer’s ID number