Form Ct-120 - Resale Certificate For Telecommunication Purchases printable pdf download

Form Ct-120 - Resale Certificate For Telecommunication Purchases

CT-120

New York State Department of Taxation and Finance

Resale Certificate for

(11/12)

Telecommunication Purchases

Single-use certificate

Blanket certificate

Date issued

Telecommunication services provider information — please type or print

Name

Address

City

State

ZIP code

Telecommunication services reseller certification

I, the reseller, certify that:

• I am a reseller of telecommunications services. My valid sales tax Certificate of Authority number issued by the Tax

Department is

• I am purchasing telecommunication services for resale as telecommunication services.

• I understand I may not use this certificate to purchase telecommunication services that are not for resale as

telecommunication services.

• If I purchase telecommunications for resale as telecommunication services, but I use the services myself, or do not resell the

services as telecommunication services, I must report and pay the unpaid tax directly to New York State.

• I understand I will incur tax liabilities, in addition to penalty and interest, for any misuse of this certificate.

I certify that the above statements are true and correct. I make these statements with the knowledge that knowingly making a

false or fraudulent statement on this document is a misdemeanor under Tax Law section 1817 and Penal Law section 210.45,

punishable by imprisonment for up to a year and a fine of up to $10,000 for an individual or $20,000 for a corporation. I

understand that the Tax Department is authorized to investigate the validity of the exemption claimed or the accuracy of any

information entered on this form.

Please type or print

Reseller’s name as it appears on the sales tax Certificate of Authority

Name of owner, partner, or officer of corporation, authorizing the purchase

issued by the Tax Department

Street address

Purchase authorizer’s signature

City

State

ZIP code

Purchase authorizer’s title

Substantial penalties will result from misuse of this certificate.

Form Ct-120 - Resale Certificate For Telecommunication Purchases