Form Ft-1000 - Certificate Of Prepayment Or Payment Of Taxes On Diesel Motor Fuel (Page 2 of 2) in pdf

Page 2 of 2 FT-1000 (6/12)

Instructions

General Information

greater of either the prepaid sales tax or the sales tax computed on the

retail selling price.

Seller

Mark an X in box b if your customer is a bulk user who is purchasing

All diesel motor fuel is subject (until proven otherwise) to the following

for taxable personal use (for example, a truck fleet operator).

state taxes: diesel motor fuel tax, sales tax, and petroleum business

tax.

Mark an X in box c if no prepaid sales tax or retail sales tax is due.

You may not use this certificate as a blanket certificate for transactions

Part 2

that are exempt from all three taxes. For those transactions, use

Form FT-1000-A, Certification of Exclusion of Sales, Diesel Motor Fuel,

Mark an X in box d and enter the amount of diesel motor fuel tax per

gallon. Also mark an X in the other appropriate box and, if applicable,

and Petroleum Business Taxes from Selling Price.

enter the name and registration number of the dealer who paid the tax;

Diesel motor fuel is No. 1 diesel fuel, No. 2 diesel fuel, biodiesel,

kerosene, fuel oil or other middle distillate and also motor fuel suitable

for use in the operation of an engine of the diesel type. It does not

Mark an X in box e if the selling price of the fuel does not include any

include any product specifically designated as No. 4 diesel fuel.

diesel motor fuel tax.

Seller certification requirements

Part 3

No certification is required on retail sales of residential or nonresidential

Mark an X in box f if the selling price of the fuel includes the petroleum

heating or on fuel delivered directly into the fuel tank of a diesel-

business tax and enter the amount of petroleum business tax per

powered motor vehicle. On every other sale of diesel motor fuel that

gallon. Also mark an X in the appropriate box to indicate who is

is subject to one of the state taxes, you must give the purchaser, at or

certifying to the payment of petroleum business tax.

before the time of delivery of the fuel, either:

Mark an X in box g if no petroleum business tax was included in the

• a properly completed Form FT-1000 (an original or a photocopy); or

selling price for the product indicated.

• a delivery ticket invoice, or other billing document containing all of

Preliminary certification

the following information:

If it is impossible to provide a complete certification at the time of

delivery using either this certificate, a delivery ticket, or an invoice

— date of sale

or other billing document, the seller may request permission to use

— seller’s name and address

the preliminary certification procedure. Any preliminary certification

must be followed within 10 days by a complete certification, using

— seller’s diesel motor fuel registration number and NYS sales tax

Form FT-1000 or an invoice or billing document containing all of the

ID number

information listed under Seller certification requirements.

— purchaser’s name and address

Signature

— type of diesel product delivered

Form FT-1000 (an original or photocopy) is not valid unless it bears

an original signature of the seller or an authorized representative (the

— number of gallons sold

signature may not be photocopied on another Form FT-1000).

— amount (per gallon) of the prepaid sales tax included in the

Purchaser

delivered price of the actual amount of retail sales tax being

collected, and an indication of which, if either, was charged

Attach this certificate (if applicable) to the invoice(s) or delivery ticket(s)

covering the above purchase and keep these documents as part of

— amount (per gallon) of diesel motor fuel excise tax charged or

your records for at least three years.

passed through, if applicable

— amount (per gallon) of petroleum business tax included in the

price, if applicable

Need help?

— certification: I certify that the amount of tax shown has been

or will be paid by me or my supplier; or if no diesel motor fuel

Visit our Web site at

tax, sales tax or petroleum business tax is shown, I certify

that no such taxes are being charged on the product based

• get information and manage your taxes online

on an exemption.

• check for new online services and features

When a delivery ticket is given before or at the time of delivery, you

may certify to the tax rate being charged if the sales tax due at retail

cannot be determined at that time. However, you must subsequently

Telephone assistance

give the purchaser an invoice separately stating the actual amount of

Miscellaneous Tax Information Center: (518) 457-5735

sales tax charged.

To order forms and publications:

(518) 457-5431

Specific Instructions

In the entry fields provided, enter the invoice number (or delivery

Text Telephone (TTY) Hotline (for persons with hearing

ticket number), the specific fuel type (non-highway diesel motor fuel or

and speech disabilities using a TTY): If you have

highway diesel motor fuel) being sold, and the number of gallons sold.

access to a TTY, contact us at (518) 485-5082.

If you do not own a TTY, check with independent

Part 1

living centers or community action programs to find

Mark an X in box a and enter the amount of prepaid sales tax per

out where machines are available for public use.

gallon. Also mark an X in the other appropriate box if:

Persons with disabilities: In compliance with the

• your customer is a distributor or a retailer, purchasing

Americans with Disabilities Act, we will ensure

highway diesel motor fuel for resale; or

that our lobbies, offices, meeting rooms, and other

• your customer is a retailer (including a distributor of kero-jet fuel

facilities are accessible to persons with disabilities. If

only) purchasing non-highway diesel motor fuel for resale.

you have questions about special accommodations

If a distributor purchases highway diesel motor fuel in volume or if

for persons with disabilities, call the information

a filing station operator purchases highway diesel motor fuel, the

center.

purchaser must provide the seller with Form FT-1002, Certification of

Use of Diesel Motor Fuel Purchased in Volume, or must charge the

Form Ft-1000 - Certificate Of Prepayment Or Payment Of Taxes On Diesel Motor Fuel Page 2

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