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Page 2 of 2 FT-1012 (6/12)
Part 4 — Residual petroleum product (If less than 100% of the product is to be used for manufacturing as stated
above, check this box and indicate the appropriate percentages (must total 100%) of use.)
a I certify that % of the product is to be used in the production of tangible personal property for sale as described above (must
be supported by an engineering study).
b I certify that % of the product is to be used for residential heating purposes. (This sale is exempt from the petroleum business
tax and the New York State sales tax but, if applicable, subject to local sales tax.)
c I certify that % of the product is to be used for nonresidential (commercial) heating purposes. (This sale is subject to the
petroleum business tax at the nonresidential heating rate for residual petroleum product and to the New York State and local sales taxes.)
d I certify that % of the product is to be used for any other purposes than that stated above except if you are a rate-regulated
electric corporation using the product in generators to produce electricity. (This sale is subject to the petroleum business tax at the
commercial gallonage rate for residual petroleum product and to the New York State and local sales taxes, unless a valid exemption
document is completed and given to the supplier.)
Note: Kerosene is exempt from the petroleum business tax when sold by a petroleum business registered as a distributor of diesel motor fuel or a retailer
of non-highway diesel motor fuel only and the kerosene is not mixed or blended with other products, is not sold with any other petroleum product, or
is not sold or used to operate motor vehicles or delivered into a tank equipped with a nozzle.
Certification: I certify that the above statements are true and complete, and I make these statements with the knowledge that willfully issuing a false
or fraudulent certificate with the intent to evade tax is a misdemeanor under New York State Tax Law sections 1812(c)(4), 1812-f(c)(4), and 1817(m)
and Penal Law section 210.45, punishable by a fine up to $10,000 for an individual or $20,000 for a corporation. I also understand that the Tax
Department is authorized to investigate the validity of exemptions claimed or the accuracy of any information entered on this form.
Signature of purchaser or authorized representative Title Date
Instructions
General information Dyed diesel motor fuel means diesel motor fuel which has been dyed in
accordance with and for the purpose of complying with the provisions
This certificate can be used to claim exemption from the taxes (the of 26 USC 4082(a).
petroleum business tax, diesel motor fuel tax, and sales and use tax)
on non-highway diesel motor fuel and residual petroleum product Residual petroleum product is the topped crude of refinery operations
as indicated on the front. You may use it for a single purchase or for including No. 5 fuel oil, No. 6 fuel oil, bunker C, and that special grade
blanket purchases of one specific type of product. of diesel product designated No. 4 diesel fuel, that is not suitable
for use in the operation of a motor vehicle engine. This product is
This certificate may not be used to purchase fuel for use in farm sometimes used for the production of electric power, space heating,
production; use Form FT-1004, Certificate for Purchases of vessel bunkering, and other industrial purposes.
Non-Highway Diesel Motor Fuel or Residual Petroleum Product for
Farmers and Commercial Horse Boarding Operations.
Need help?
Directly means the fuel must, during the production phase of a
process, operate exempt production machinery or equipment, or Visit our Web site at www.tax.ny.gov
create conditions necessary for production, or perform an actual part
of the production process. • get information and manage your taxes online
• check for new online services and features
Exclusively means that all of the fuel is used entirely (100%) in the
production process. Telephone assistance
Production includes the production line of the plant, starting with the
handling and storage of raw materials at the plant site and continuing Miscellaneous Tax Information Center: (518) 457-5735
through the last step of production where the product is finished and To order forms and publications: (518) 457-5431
packaged for sale.
Text Telephone (TTY) Hotline (for persons with
Manufacturing means the production of tangible personal property that hearing and speech disabilities using a TTY): (518) 485-5082
has a different identity from its ingredients.
Processing means the performance of any service on tangible personal Persons with disabilities: In compliance with the
property that changes the nature, shape, or form of the property. Americans with Disabilities Act, we will ensure that our
lobbies, offices, meeting rooms, and other facilities are
Assembly means the coupling or the uniting of parts or materials as accessible to persons with disabilities. If you have questions
a manufacturing process or a step in the manufacturing process that about special accommodations for persons with disabilities, call
results in a new product. the information center.
Diesel motor fuel means No. 1 diesel fuel, No. 2 diesel fuel, biodiesel,
kerosene, fuel oil or other middle distillate and also motor fuel suitable
for use in the operation of an engine of the diesel type. It does not
include any product specifically designated No. 4 diesel fuel.
Non-highway diesel motor fuel means any diesel motor fuel that is
designated for use other than on a public highway (except for the use
of the public highway by farmers to reach adjacent lands), and is dyed
diesel motor fuel.
Highway diesel motor fuel means any diesel motor fuel which is not
non-highway diesel motor fuel.
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