Form Ft-1011 - Claim For Partial Refund Of The New York State Motor/diesel Motor Fuel Tax By A Taxicab Licensee Page 2
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2Page 2 of 2 FT-1011 (9/11)
Instructions
Who may use this form
A claim for refund or reimbursement of tax paid on motor/diesel motor
fuel must be based on records (including the original records of all
A taxicab licensee may file this form to obtain a refund for motor/diesel
purchases of motor/diesel motor fuel by the claimant and a record of
motor fuel consumed in a taxicab in this state. Note: Form TP-164.8 is
the manner in which all motor/diesel motor fuel was used). These
no longer in use.
records must be kept for three years and be produced at any time for
Taxicab licensee means every corporation, company, association,
audit by the Tax Department.
partnership, and person engaged in operating a taxicab, as defined
in the Vehicle and Traffic Law, section 148-a and licensed by local
Where to file
authorities (as defined in the Vehicle and Traffic Law, section 122) to
Mail to:
NYS TAX DEPARTMENT
operate at a fixed rate of fare.
FUEL TAX REFUND UNIT
Section 148-a of the Vehicle and Traffic Law defines a taxicab as:
PO BOX 5501
ALBANY NY 12205-5501
Every motor vehicle, other than a bus, used in the business of
transporting passengers for compensation, and operated in such
Private delivery service address — To use a private delivery service,
business under a license issued by a local authority. However, it shall
see Publication 55, Designated Private Delivery Services.
not include vehicles which are rented or leased without a driver.
B20 means a mixture consisting by volume of 20% biodiesel and the
remainder of which is diesel motor fuel.
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Biodiesel means either qualified biodiesel or unqualified biodiesel.
Qualified biodiesel means a diesel motor fuel substitute produced
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from nonpetroleum renewable resources that meets the registration
(for information, forms, and online services)
requirements for fuels and fuel additives established by the
Environmental Protection Agency under section 211 of the Clean
Miscellaneous Tax Information Center:
(518) 457-5735
Air Act (42 USC 7545) and that meets the ASTM International active
standard D6751 for biodiesel fuel.
To order forms and publications:
(518) 457-5431
Unqualified biodiesel means a diesel motor fuel substitute produced
from nonpetroleum renewable resources that does not meet the ASTM
Text Telephone (TTY) Hotline
International active standard D6751 for biodiesel fuel.
(for persons with hearing and
speech disabilities using a TTY):
(518) 485-5082
A tax may not be refunded until it has first been collected and verified
pursuant to Tax Law, section 289-c, subdivision 3(c).
The state does not collect until the month following that in which the
Privacy notification
tax was paid by the purchaser. For example, refunds for the month
The Commissioner of Taxation and Finance may collect and maintain personal information pursuant
of March cannot be made until the Tax Department has received the
to the New York State Tax Law, including but not limited to, sections 5-a, 171, 171-a, 287, 308,
tax due the state from the distributor late in April, and similarly for the
429, 475, 505, 697, 1096, 1142, and 1415 of that Law; and may require disclosure of social security
numbers pursuant to 42 USC 405(c)(2)(C)(i).
succeeding months.
This information will be used to determine and administer tax liabilities and, when authorized by
Claims for refunds must cover a complete calendar month. No refunds
law, for certain tax offset and exchange of tax information programs as well as for any other lawful
will be made by the department for purchases made more than
purpose.
three years before the date of filing the claim.
Information concerning quarterly wages paid to employees is provided to certain state agencies
for purposes of fraud prevention, support enforcement, evaluation of the effectiveness of certain
You must submit copies of sales invoices, delivery tickets, or
employment and training programs and other purposes authorized by law.
monthly statements showing name and address of dealer, name and
Failure to provide the required information may subject you to civil or criminal penalties, or both,
address of claimant, date of purchase (month, day and year), number
under the Tax Law.
of gallons purchased, and the fact that the tax was included in the
This information is maintained by the Manager of Document Management, NYS Tax Department,
purchase price.
W A Harriman Campus, Albany NY 12227; telephone (518) 457-5181.
Summary of Motor Fuel Purchases
Schedule A — Bulk purchases
Schedule B — Purchases at filling stations
Date of purchase
Date of purchase
Purchased
Total gallons
Purchased
Total gallons
from
purchased
from
purchased
Month
Day
Year
Month
Day
Year
......
Total bulk purchases
Total purchases at filling stations
(enter here and on line 7, column A)
(enter here and on line 8, column A)
Summary of Diesel Motor Fuel Purchases
Schedule C — Bulk purchases
Schedule D — Purchases at filling stations
Date of purchase
Date of purchase
Purchased
Total gallons
Purchased
Total gallons
from
purchased
from
purchased
Month
Day
Year
Month
Day
Year
Total bulk purchases
........
Total purchases at filling stations
(enter here and on line 7, column B)
(enter here and on line 8, column B)
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