Form 637 - Application For Registration (For Certain Excise Tax Activities) Page 2
Download a blank fillable Form 637 - Application For Registration (For Certain Excise Tax Activities) 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 637 - Application For Registration (For Certain Excise Tax Activities) 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
2
3
4
5
62
Form 637 (Rev. 8-2012)
Page
Section C—For Certain Fuel Applicants
If you are applying for fuel activities K, M, S, W, or Y, answer each question below by checking the “Yes” or “No” box. If you answer
“Yes” to any of these questions, provide a full explanation. Attach additional sheets if needed.
Have you or any related person (see Regulations section 48.4101-1(b)(5)) been:
10
Assessed any penalty under chapter 68 of the Internal Revenue Code (or similar provision of the law of any
state) for fraudulently failing to file any return or pay any tax, and the penalty has not been wholly abated,
refunded, or credited?
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
Yes
No
Assessed any penalty under chapter 68 of the Internal Revenue Code, and the penalty has not been wholly
11
abated, refunded, or credited? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
Yes
No
12
Convicted of a crime under chapter 75 of the Internal Revenue Code (or similar provision of the law of any
state), or of conspiracy to commit such a crime, and the conviction has not been wholly reversed by a court
of competent jurisdiction?
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
Yes
No
13
Convicted, under the laws of the United States or any state, of a felony for which an element of the offense is
theft, fraud, or the making of false statements, and the conviction has not been wholly reversed by a court of
competent jurisdiction? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
Yes
No
Assessed any tax under section 4103 (willful failure to pay the tax imposed by section 4041(a)(1) or 4081)
14
and the tax has not been wholly abated, refunded, or credited? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
Yes
No
15
Yes
No
Advised that your registration has been revoked?
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
Under penalties of perjury, I declare that I have examined this application, and accompanying schedules and statements, and, to the best of my knowledge
and belief, they are true, correct, and complete.
Sign
Here
Title
Signature
Date
Type or print name below your signature.
Activity Letter
Additional Information Required
A
Manufacturer of gas guzzler automobiles,
1. List all articles manufactured. Include advertising brochures, if available.
sport fishing equipment (including fishing
2. List the organizations or businesses (for example, state or local government or school) to
rods and fishing poles), fishing tackle
which you intend to sell articles tax free.
boxes, bows, quivers, broadheads,
3. List the monthly volume of tax-free articles you intend to sell. Also, list the monthly volume
points, arrow shafts, taxable tires,
of taxed articles you intend to sell.
taxable medical devices, or vaccines.
1. List articles you intend to purchase for further manufacturing or for resale for use by the
B
Buyer of sport fishing equipment
buyer for further manufacturing.
(including fishing rods and fishing poles),
fishing tackle boxes, gas guzzler
2. List the businesses that articles will be sold to for use in further manufacturing, if applicable.
automobiles, bows, quivers, broadheads,
3. List other types of sales of articles other than for further manufacturing.
points, taxable medical devices, or
vaccines for further manufacture or for
resale to a buyer for further manufacture.
1. List the type and weight of the tires being bought.
C
Buyer of taxable tires for use on or in
connection with the sale of another
2. List the articles manufactured (1) on which the tires will be used or (2) in connection with
article the buyer manufactures and sells
which the tires will be sold.
(1) for export, (2) to state and local
3. List the organizations or businesses with which you intend to have tax-exempt sales.
governments, (3) to nonprofit educational
organizations, or (4) as supplies for
vessels or aircraft.
Buyer with a place of business in the
1. List the articles you intend to buy for export or resale to others for export.
D
United States purchasing taxable medical
2. List the businesses to which you intend to sell articles for export.
devices, vaccines, gas guzzler
automobiles, taxable tires, sport fishing
equipment (including fishing rods and
fishing poles), fishing tackle boxes, bows,
quivers, broadheads, points, or arrow
shafts for export or for resale to a second
purchaser for export.
637
Form
(Rev. 8-2012)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Rv-f1303601 - Application For Franchise, Excise Tax Registration - State Of Tennessee
Financial
Form B-a-18cr - Application For Cigarette Excise Tax Refund For North Carolina Tax-paid Packs Returned To Manufacturer
Financial
Related Categories
Parent category: Financial