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Form St-810.10 - Quarterly Schedule Fr For Part-Quarterly (Monthly) Filers - Sales And Use Tax On Qualified Motor Fuel And Highway Diesel Motor Fuel - 2015

Quarterly Schedule FR for

Part-Quarterly (Monthly) Filers

Department of Taxation and Finance

Sales and Use Tax

File as an attachment to Form ST-810

on Qualified Motor Fuel and

For 3rd quarter tax period:

September 1, 2015, through November 30, 2015

Highway Diesel Motor Fuel

Include with

Form ST-810

Due date:

Monday, December 21, 2015

0916

Sales tax identification number

Legal name

(Print ID number and name as shown on Form ST-810 or Certificate of Authority)

Please see Form ST-810.10-I, Quarterly Schedule FR for Part-Quarterly (Monthly) Filers Instructions, before completing this schedule.

STEP 1 – Summary of gallons sold or used

Taxable gallons sold or used — Motor fuel

Nontaxable gallons sold or used

Taxable gallons sold or used

Regular

Mid-grade

Premium

Highway diesel motor fuel

Motor fuel

Highway diesel motor fuel

gal.

Gross sales of motor fuel and highway diesel motor fuel

STEP 2 – Summary of gross sales and total credits

including exempt sales ..................................................

.00

Total credits against tax on motor fuel and highway diesel motor fuel (except prepaid credits). See instructions for additional information. ..............................

If you made taxable sales or uses of qualified fuel during this period, you must complete Step 3 to report the New York State (and

MCTD, if applicable) portion of the sales tax due. Report the local taxes due in Steps 4 or 5, as applicable. (Sales and uses of B20

biodiesel are reported in Steps 3A, 4A, and 5.)

STEP 3 – Calculate New York State/MCTD tax (cents-per-gallon rate)

Column C

Column F

Column E

Column B

Column D

Column A

Motor fuel

Cents-per-

Sales and use tax

Jurisdiction

Highway diesel motor fuel

Taxing jurisdiction

number of taxable gallons

gallon rate

(C + D) x E

code

number of taxable gallons

New York State only

NE R0018

.08

*New York State/MCTD

NE R8064

.0875

* The MCTD consists of New York City and the counties of Dutchess,

Nassau, Orange, Putnam, Rockland, Suffolk, and Westchester.

Column total (Step 3):

Enter this amount in

Step 5, in box 6.

STEP 3A – Calculate New York State/MCTD tax (cents-per-gallon rate) on B20 biodiesel only

Column C

Column D

Column E

Column B

Column A

Number of taxable

Sales and use tax

Jurisdiction

Cents-per-

Taxing jurisdiction

gallons of B20 biodiesel

gallon rate

(C x D)

code

New York State only

NE R0016

.06

New York State/MCTD

NE R8046

.066

Column total (Step 3A):

Enter this amount in

Step 5, in box 7.

STEP 4 – Calculate local sales tax by jurisdiction (cents-per-gallon rate)

Column C

Column D

Column E

Column F

Column A

Column B

Motor fuel

Highway diesel motor fuel

Cents-per-

Sales and use tax

Taxing jurisdiction

Jurisdiction

number of taxable gallons

gallon rate

(C + D) x E

code

Seneca County

SE R4528

.08

Column total (Step 4):

Enter this amount in

Step 5, in box 8.

81000111150094

ST-810.10 (11/15) Page 1 of 4

Form St-810.10 - Quarterly Schedule Fr For Part-Quarterly (Monthly) Filers - Sales And Use Tax On Qualified Motor Fuel And Highway Diesel Motor Fuel - 2015

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