Form 325 - Application For Cash Purchase Of Alaska Oil And Gas Production Tax Credit Certificates

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Alaska
325
Application for Cash Purchase of Alaska Oil
and Gas Production Tax Credit Certificates
under AS 43.55.028
Federal EIN
Tax Year
Contact Person
Taxpayer Name
Title
Mailing Address
Contact Email Address
City
State
Zip Code
Contact Phone Number
Contact Fax Number
Tax Credit Certificate
under AS 43.55.023 or AS 43.55.025:
Tax Credit
Tax Credit
Amount Requested for
Certificate Number
Certificate Amount
Cash Purchase
Total from Attached Pages
$
Total Cash Purchase Requested
0.00
Schedule A must be attached to certify that all conditions are met under AS 43.55.028(e).
I declare under penalty of perjury that I am authorized to sign on behalf of the taxpayer for this application and each attachment has been
examined by me and to the best of my knowledge and belief is true, correct and complete.
Signature
Date
Printed Name
Printed Title
DEPT USE ONLY
This form is available online at
Submit completed applications via the Department’s Online
Tax Information System (OTIS) at .
325
Mail to: Alaska Department of Revenue, 550 W 7th Ave STE 500, Anchorage AK 99501-3555
0405-325 Rev 01/13 - page 1

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