Form Pt-101 - Tax On Motor Fuel (Includes Aviation Gasoline) (Page 2 of 2) in pdf

Page 2 of 2 PT-101 (11/15)

Combined

Gallons

tax rate

Tax

13 Taxable gallons to be accounted for

(enter the number of gallons

from line 12, column B)

................................................................... 13

Partially taxable sales and uses

14 Sales to New York State, its municipalities or to the U.S.

(from Form PT-101.3, Part 1)

$.0005 = $

government

...................................... 14

15 Exempt sales on Indian reservations

(from Form PT-101.3, Part 2)

$.0005 = $

..... 15

16 Sales to exempt diplomats and missions by credit card

(from Form PT-101.3, Part 3)

$.0005 = $

.......................................................... 16

17 Sales to exempt hospitals and other nontaxable distributions

(from Form PT-101.3, Part 4, Section A and B)

$.1785 = $

.................................. 17

18 Aviation gasoline use, storage, or sales to retail sellers of

(from Forms PT-101.3, Part 5, and PT-101.4, line 3)

$.0715 = $

aviation gasoline

.. 18

19 Sales of E85 to filling stations

(from Form PT-101.3, Part 6)

$.0005 = $

.............. 19

20 Partially taxable sales and uses

(add lines 14 through 19 in both columns)

Fully taxable gallons

21 Fully taxable gallons

(subtract line 20 from line 13 in column A)

.......... 21

22 Gallons purchased with the taxes included

(from Form PT-101.1)

.... 22

23 Net taxable gallons

(subtract line 22 from line 21 and multiply by the

tax rate; enter the result in column B)

$.2585 = $

................................................ 23

24 Tax subtotal

(add lines 20 and 23 in column B)

.................................... 24

Other taxes and adjustments

25 Sales or use of LPG (liquified petroleum gas)

(from Form PT-101.5, Part 2)

$.0805 = $

.......................................................... 25

26 Sales or use of CNG (compressed natural gas)

(from Form PT-101.5, Part 3)

$.0005 = $

.......................................................... 26

27 Tax due before adjustments

(add lines 24, 25, and 26 in column B)

28 Adjustments

(enter the net gallon adjustment in column A and the tax

Explain:

adjustment result in column B)

Balance due/credit

.............................................................. 29 $

(line 27 and add or subtract line 28 in column B)

29 Total tax/credit due

Transfer the amount on line 29 to Form PT-100, Petroleum Business Tax Return, line 1.

Note: All filers of Form PT‑101 must also complete Form PT‑101.5, Part 1, Sales or use of motor fuel (see instructions). This form

must be completed even though the total number of gallons shown on this summary is not to be indicated on any line of the tax return.

Failure to complete this required summary will result in additional correspondence and delay in processing your return.

Rate-per-gallon explanation chart

.0005 - includes the rate for petroleum testing fee only

.0715 ‑ includes the rates for petroleum business tax at the retail sellers of aviation gasoline rate (.071) and petroleum

testing fee (.0005)

.0805 - includes the rates for motor fuel excise tax (.08) and petroleum testing fee (.0005)

.1785 ‑ includes the rates for petroleum business tax (.178) and petroleum testing fee (.0005)

.2585 ‑ includes the rates for motor fuel excise tax (.08), petroleum business tax (.178), and petroleum testing fee (.0005)

Attach this form to New York State Form PT-100, Petroleum Business Tax Return.

Form Pt-101 - Tax On Motor Fuel (Includes Aviation Gasoline) Page 2

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