Form Dmf-2 - Application For Recognition As A Qualified Distributor Page 2
Download a blank fillable Form Dmf-2 - Application For Recognition As A Qualified Distributor in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Dmf-2 - Application For Recognition As A Qualified Distributor with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Section 5 – Bond information
Bond or Security must be 3 times the liability for the estimated gallons handled per month.
List estimated gallons to be handled per month by product types as grouped below
Diesel & Kerosene (dyed &
Gasoline
Aviation Gasoline
Jet Fuel
undyed)
Check type of Security to be used
Certificate of
Cash
Proof of Financial
Surety Bond
Letter of Credit
Deposit
Deposit
Responsibility
Issue of Security Instrument
Number
Issue Date
Amount
Address of Issuer
City, State Zip
Section 6 – Application to be a Qualified Distributor
Pursuant to Section 54:39-121, Qualified Distributors may delay remittance of the tax precollected by their Suppliers and Permissive
Suppliers until up to the 20
day of the month following the removal of taxable products from a terminal by a fuel transportation
th
vehicle. Payments made to Suppliers and Permissive Suppliers MUST be made by EFT.
We acknowledge our Suppliers’ obligations to precollect tax due on Motor Fuels from us, hold it
in trust for New Jersey, and remit the tax precollected no later than the 22
of the month following the
nd
taxable event.
We affirm that:
1. Our company was a licensee in good standing with the State of New Jersey under R. S.
54:39-1 et seq. Our filings and payments were made accurately and timely
— OR —
2. Our company meets the financial responsibility or bonding requirements set forth by the
Motor Fuels Tax Act of 2010.
We agree that in order to enable our Suppliers to meet their obligations to the State of New
Jersey, we MUST remit the amount of tax due to our Suppliers by EFT no later than the 20
day of the
th
month following the taxable event.
Based on the above acknowledgment, affirmation, and agreement, we request that the State
of New Jersey recognize the applicant as qualified to delay remittance to Suppliers of tax due until the
20
day of the month following the taxable event.
We recognize that as a Qualified Distributor,
th
recognized pursuant to R. S. 54:39-101, that our company, and not our Suppliers, will be liable for
penalties and interest in the event that we make remittance to our Suppliers late. We further recognize
that a late remittance to our Suppliers will revoke our status as a Qualified Distributor.
QUALIFIED DISTRIBUTOR APPLICATION must be signed by an authorized representative of the company
as listed in Section 5 of MFA-1, License Application.
Signature
Title
Printed Name
Date Signed
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Qba - Virginia Application For Designation As A Qualified Business For The Qualified Equity And Subordinated Debt Investments Tax Credit
Financial
Form Rpd-41347 - Application For Designation As A Qualified Intermediary - State Of New Mexico Taxation And Revenue Department
Financial
Form Qba - Application For Designation As A Qualified Business For The Ar Year Application For Designation As A Qualified Business For The Form Qba Q
Financial
Form Qba - Application For Designation As A Qualified Business For The Qualified Equity And Subordinated Debt Investments Tax Credit - Virginia Department Of Taxation
Financial
Form Qba - Application For Designation As A Qualified Business For The Qualified Equity And Subordinated Debt Investments Tax Credit
Financial
Form Qba - Application For Designation As A Qualified Business For The Qualified Equity And Subordinated Debt Investments Tax Credit
Financial
Related Categories
Parent category: Financial