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Form Pt-101.4 - Aviation Gasoline Consumed In New York State By Aircraft Of Distributors Of Motor Fuel

New York State Department of Taxation and Finance

PT-101.4

Aviation Gasoline Consumed in New York State

(9/06)

By Aircraft of Distributors of Motor Fuel

Read instructions on the back carefully. Keep a copy of this completed form for your records.

Name of distributor

FEIN

Month/year

Computation of aviation gasoline consumed in New York State by aircraft.

If you qualify as an exempt aircraft operator, mark an X in the box and complete the columns below. Also, read the Note in

the instructions on the back to compute the petroleum testing fee on the gallons exempt from the petroleum business tax

but subject to the petroleum testing fee.

Exempt aircraft operator - I provide regularly scheduled passenger service to four or more cities within New York

State and provide nonstop service between any four of those cities

(see instructions)

Type of aircraft

Number of flights taking off from

Gallons of aviation gasoline per

Gallons of aviation gasoline

within New York State

departure

consumed in New York State

(see instructions)

(column B × column C)

1 Total gallons of aviation gasoline consumed in New York State

(Add the column D amounts; enter 0 if you

marked the box above and you qualify as an exempt aircraft operator for the entire month. If you qualify for

the exemption for only part of the month, you must include on this line the gallons consumed during the

.....................................................................................................................................

nonexempt part.)

....................

2 Total gallons of aviation gasoline purchased tax‑paid and consumed in your aircraft

3 Taxable gallons

(subtract line 2 from line 1; show any negative amount in brackets) (Enter here and include

....................................................................................

in the amount on Form PT-101, line 18.)

Form Pt-101.4 - Aviation Gasoline Consumed In New York State By Aircraft Of Distributors Of Motor Fuel