A 1730‐  
Rev.06 2011 ‐  ct                                       State of New Jersey                                  For Official Use Only 
                                                        DIVISION OF TAXATION                                 Claim No.
                                                    CLAIM FOR REFUND OF 
                                                 PAID AUDIT ASSESSMENT 

  File this claim with:  
  Division of Taxation  
  Attn: Audit Claims Processing  
  PO Box 275  
  Trenton, NJ  08695-0275 
                          PLEASE PRINT OR TYPE THE REQUESTED INFORMATION. (See instructions on reverse side.) 

  Federal Identification No. OR Social Security No. 

  Name of Taxpayer 

  Trade Name (if different from legal name) 

  Address (number and street) 

  C ity                                                                               S ta te                Z ip  C o d e

  1.     A separate form must be completed for each tax. Check the one box below that indicates the tax audited and paid, upon which
         this claim is based
                   Corporation Business Tax                                    Sales and Use Tax 
                   Estate Tax                                                  Tobacco & Nicotine Products Wholesale Sales& Use Tax    
                   Gross Income Tax                                            Transfer Inheritance Tax 
                   Petroleum Products Gross ReceiptsTax                        Other  _______________________________ 
  2.      Tax Period(s) included in this claim

  3. Date of Audit Assessment
     Submit a copy of the Audit Assessment Notice
  4. Date of expiration of Protest/Appeal Period
  5. Was a protest/appeal filed on this tax assessment?     Yes         No
     If yes, you are not eligible to file a refund claim.  Only taxpayers who have paid an assessed deficiency within one year after the
     expiration of the period allowed for filing a protest, and who have NOT protested or appealed that assessment, may file a claim for
     refund.  N.J.S.A. 54:49-14.
  6. Was the assessment paid in full including penalty and interest?         Yes               No
        Date of Payment           .  Submit a copy of the canceled check that paid the assessment.  If the check also includes payments 
        for other taxes, submit a schedule listing the taxes, tax periods and dollar amounts totaling the check amount. 
  7.  Was an abatement granted?            Yes            No    
   If an abatement of penalty was granted taxpayer is NOT eligible to file A-1730.  N.J.A.C. 18:2-5.5(c)1.ii 
  8. Amount of Refund Claim $
               A detailed explanation of the Claim must be attached to this form with the supporting documents 
               to substantiate the claim.  Issues are limited to those on the deficiency tax assessment and shall 
               not include any additional issues with respect to the original assessment of tax. 
  9. Appointment of Taxpayer Representative.  Is an Appointment of Taxpayer Representative necessary?
   Yes                No       If yes, provide a copy of the Appointment of Taxpayer Representative with this claim form. 

  Under penalties of perjury, I declare that I have examined this claim, including all accompanying schedules and statements, and to the best of my 
  knowledge and belief, it is true, correct and complete.  Declaration of preparer is based on all information of which preparer has any knowledge. 
  Signature of Claimant/Preparer                                                                        Date 
  If the preparer of this claim has been paid, indicate the firm’s name, address, the firm’s Federal EIN and the preparer’s Social Security Number, 
  Federal Identification Number or Federal Preparer Tax identification Number. 
  Firm’s Name                                                                         Preparer’s SS# or Federal PTIN

  Firm’s Address                                                                      Preparer’s Federal EIN

   Instructions for Form A-1730  

 1. This form only applies to tax periods that begin on or after January 1, 1999.  
  
 2. A taxpayer must file Form A-1730 to claim a refund of an additional tax assessment, which 
   was paid in full including penalty and interest within one year after the expiration of the period 
   allowed for filing a protest, but for which a protest or appeal was not filed. If an abatement of 
   penalty was granted, the taxpayer is NOT eligible to file A-1730. 
  
 3. The claim must clearly show in detail each position upon which the claim is based and 
   contain sufficient facts and documentation to substantiate the claim. A separate claim form 
   must be completed for each tax.  
  
 4. Include a copy of the canceled check used to pay the assessment that is the basis for this 
   claim. If an electronic funds transfer was used, submit a copy of the bank receipt.  
  
 5. If the payment included other tax periods for which a refund claim is not being made, attach 
   a schedule listing all taxes, tax periods and amounts included in the payment. 
   
 6. Whenever an agent on behalf of the taxpayer executes a claim, an Appointment of Taxpayer 
   Representative specifically authorizing such agent to act on behalf of the taxpayer must 
   accompany the claim for refund form.  
  
 7. Mail this claim for refund to: New Jersey Division of Taxation, Attn: Audit Claims Processing, 
   PO Box 275, Trenton, NJ  08695-0275.  
  
 8. Failure to complete all required lines on Form A-1730 or to attach proper documentation may 
   result in the claim being denied.   
  
 9. Form A-1730 will not be accepted for the following assessments that are not additional tax  
   assessments and therefore are not eligible for a refund under the provisions of N.J.S.A. 
   54:49-14b and N.J.A.C. 18:2-5.5(c)5. 
  
   1. Jeopardy Assessments 
   2. Delinquent Assessments 
   3.  Estimated or Arbitrary Assessments 
   4.  Penalty and Interest Assessments 
   5.  Self Assessed Tax 
   6.  Cost of Collection