Form Au-196.10 - Notification Of Sale, Transfer, Or Assignment In Bulk

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AU-196.10
New York State Department of Taxation and Finance
New York State and Local Sales and Use Tax
(12/10)
Notification of Sale, Transfer, or Assignment in Bulk
The following information should be submitted by registered mail at least 10 days before taking possession of or paying for the
business or property, whichever comes first. Complete this form in duplicate. Retain a copy for your records. See instructions for where
to mail.
Read instructions on page 2 before making entries below.
Section 1 - Mailing address of purchaser, seller, and escrow agent (if any)*
Purchaser or representative’s name
Seller or representative’s name
Escrow agent
Number and street
Number and street
Number and street
City, state, ZIP code
City, state, ZIP code
City, state, ZIP code
Telephone number with area code
Telephone number with area code
Telephone number with area code
(
)
(
)
(
)
Section 2 - Vendor identification*
Purchaser’s Certificate of Authority identification number
Seller’s Certificate of Authority identification number
Last day of business
Purchaser’s name
Seller’s name
Business or trade name
Business or trade name
Business location
Business location
(number and street)
(number and street)
City, state, ZIP code
City, state, ZIP code
Section 3 - Details of sale*
a) Scheduled date of sale
b) Location of property when transferred
f) Sales prices of assets sold:
1. Tangible personal property
(furniture, fixtures, etc.) .................
c) Type of business or property sold
d) Amount of escrow fund
2. Motor vehicles ..................................
e) Name of bank in which escrow fund is deposited
3. Merchandise inventory for resale .....
Address
(number and street)
4. Manufacturing equipment,
tools and supplies .............................
City, state, ZIP code
5. Real estate .......................................
6. Intangible property (goodwill, etc.) ...
Account identification
Bank telephone number
(name and number)
(
)
Total sales price ....................................
g) Terms and conditions of sale (attach copy of Contract of Sale):
*Notification in writing is required of any change in the information reported above.
New York State Sales and Use Tax Law, Article 28, section 1141(c), provides in part as follows:
Whenever a person required to collect tax shall make a sale, transfer, or assignment in bulk of any part or the whole of his business assets, otherwise than
in the ordinary course of business, the purchaser, transferee or assignee shall at least ten days before taking possession of the subject of said sale, transfer
or assignment, or paying therefore, notify the (Commissioner of Taxation and Finance) by registered mail of the proposed sale and of the price, terms and
conditions thereof whether or not the seller, transferor or assignor, has represented to, or informed the purchaser, transferee or assignee that he owes any tax
pursuant to this article, and whether or not the purchaser, transferee, or assignee has knowledge that such taxes are owing, and whether any such taxes are in
fact owing.
Certification: I,
the purchaser/seller named above, or other authorized representative of such
purchaser/seller, do hereby certify that the above statements are true, complete and correct, and that no material information has been omitted. I make these
statements with the knowledge that willfully issuing a false or fraudulent document with the intent to evade tax may constitute a felony under New York State
Law, punishable by a substantial fine and a possible jail sentence. I also understand that the Tax Department is authorized to investigate the validity and the
accuracy of any information entered on this document.
Date
Signature
Title
(if other than purchaser, please identify)
/
/
W

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