PDF document
- 1 -
                                                                                                    Quarterly Schedule W for
                     Department of Taxation and Finance                                   Part-Quarterly (Monthly) Filers
                     Report of Purchases Eligible for                               File as an attachment to Form ST-810
                     Credit by a Qualified Empire                                For 4th quarter tax period:                                                           W
                                                                                 December 1, 2020, through February 28, 2021                                           Include with  
                     Zone Enterprise (QEZE)                                                                                                                            Form ST-810
                                                                                 Due date:
                                                                                 Monday, March 22, 2021                                                                1221
 Sales tax identification number                                      Legal name (Print ID number and name as shown on Form ST-810 or Certificate of Authority)

  Caution: Your benefit period to claim QEZE credits may be expiring soon. See instructions for more information.
  If you were certified by Empire State Development (ESD) on or after April 1, 2009, you may use this schedule only if you made purchases 
  in the following jurisdictions (see instructions on page 2): Allegany County, Cayuga County, city of Auburn, Erie County, Herkimer County, 
  Montgomery County, and Niagara County.
  Note: You must also complete Form AU-12, Application for Credit or Refund of Sales or Use Tax–Qualified Empire Zone Enterprise 
  (QEZE), and mail it to the address shown on Form AU-12-I, Instructions for Form AU-12, when you take credits on this schedule.
  Do not use this form to claim a credit for the tax paid on qualifying purchases of motor fuel or diesel motor fuel. You must use 
  Form FT-500, Application for Refund of Sales Tax Paid on Petroleum Products.

 Part 1 – Verify eligibility

Empire Zone certification number from your Empire Zone Retention Certificate (EZRC)  ....

If you were certified by ESD before April 1, 2009, you must have applied for and received Form DTF-81-PC, Qualified Empire 
Zone Enterprise (QEZE) Sales Tax Certification, before claiming credits.
Has your business passed the employment test for the tax year ending before the period covered by this schedule to
verify that it is eligible to claim the QEZE credit for this reporting period? (If so, you must mark an X in the box. 
If not, stop; you are not eligible for the QEZE credit. Do not file this schedule.) ..............................................................................................

 Part 2 – Purchases eligible for credit by jurisdiction – Enter amounts of purchases eligible for credit on the appropriate 
 jurisdiction line. Only the local jurisdictions listed below are eligible for a credit of local sales tax. If a purchase was made in a local 
 jurisdiction not listed below, enter the amount on either the New York State only line or the New York State/MCTD line, as applicable. 
 Note: Only businesses certified by ESD before April 1, 2009, are allowed to claim credits on the New York State only line or the New York 
 State/MCTD line.
                 Column A                      Column B                            Column C                           Column D                                 Column E
                 Taxing jurisdiction           Jurisdiction                      Eligible purchases               × Tax rate =          Amount of sales and use tax credit
                                                       code                                                                                                    (C × D)
 New York State only                           NE  W0021                                                          .00 4%
 New York State/MCTD                           NE  W8061                                                          .00  4⅜%
 Allegany County                               AL  W0221                                                          .00  8½%
 Cayuga County                                 CA  W0511                                                          .00 8%
   Auburn (city)                               AU  W0561                                                          .00 8%
 Erie County                                   ER  W1451                                                          .00  8¾%
 Herkimer County                               HE  W2121                                                          .00  8¼%
 Montgomery County                             MO  W2781                                                          .00 8%
 Niagara County                                NI  W2911                                                          .00 8%

                                           Column totals: .00
                                                                                Include this amount as a negative                       Include this amount as a 
                                                                      on Form ST-810, page 2, Column D, in                             negative on Form ST-810, page 2, 
                                                                      box 4.                                                           Column F, in box 5. ( See instructions 
                                                                                                                                       on page 2.)

                                                                                                                                                               ST-810

                                                                                                                                        Insert Form ST-810.1
                                                                                                                                         inside Form ST-810
       80100102210094                                                                                                                                                  W
                                                                                                                                       ST-810.1 (2/21)  Page 1 of 2



- 2 -
                                                                     Report of Purchases Eligible for Credit by a
        Quarterly Schedule W for
                                                                     Qualified Empire Zone Enterprise (QEZE)
          Part-Quarterly (Monthly)                                   Report transactions for the period December 1, 2020, through February 28, 2021.
                          Filers Instructions
Caution: Your benefit period to claim QEZE credits may be            Employment test – You must complete and pass the employment 
expiring soon. For more information, see TB-ST-730, QEZE Sales       test using your employment numbers for the tax year ending before 
Tax Credit or Refund, and TSB-M-09(12)S, Changes to Qualified        the period covered by Form AU-12 to qualify for the credit.
Empire Zone Enterprise (QEZE) Program (Articles 28 and 29) –         If your credit or refund claim covers periods from more than one 
Effective September 1, 2009.                                         tax year, you must complete the employment test for each tax year 
                                                                     required.
Who may file                                                         Example: A business was certified by ESD with an effective date 
Complete and file Form ST-810.1, Quarterly Schedule W for            of February 15, 2009, on its Certificate of Eligibility. The business 
Part-Quarterly (Monthly) Filers, if you file Form ST-810, New        applied for and received QEZE sales tax certification from the Tax 
York State and Local Quarterly Sales and Use Tax Return for          Department effective October 1, 2009. The business files taxes on 
Part-Quarterly (Monthly) Filers, you made purchases eligible for     a calendar year basis. 
the qualified empire zone enterprise (QEZE) sales and use tax 
credit, and you want to claim the credit against the sales and use   At the end of December 2016, the business completed the 
tax you owe with this return.                                        employment test for the 2016 tax year (January through 
                                                                     December 2016) and determined that it qualifies for QEZE sales 
If you are taking credits on this schedule, you must also complete   tax benefits for 2017.
Form AU-12, Application for Credit or Refund of Sales or Use 
Tax – Qualified Empire Zone Enterprise (QEZE), and mail it to the    At the end of December 2017, the business completed the 
address  shown on Form AU-12-I, Instructions for Form AU-12. Do      employment test for the 2017 tax year (January through 
not attach Form AU-12 to this return.                                December 2017) and determined that it qualifies for QEZE sales 
                                                                     tax benefits for 2018.
The application must state that the credit has been claimed on a 
sales tax return and the period covered by that return. Supporting   In March 2018, the business files Form ST-810.1 to report a credit 
documentation must be filed with Form AU-12.                         for tax paid on qualifying purchases made during September 
                                                                     through December 2017 and for January through February 2018.
If you were certified by Empire State Development (ESD) before 
April 1, 2009, you must have:                                        When filing Form AU-12 to claim the credit, it must complete and 
•  applied for and received Form DTF-81-PC, Qualified Empire         attach employment test worksheets for the 2016 tax year to support 
   Zone Enterprise (QEZE) Sales Tax Certification;                   its claim for a credit for the September through December 2017 
                                                                     period, and for the 2017 tax year to support its claim for the January 
•  received your Empire Zone Retention Certificate (EZRC) from       through February 2018 period.
   ESD; and
passed the employment test for the tax year ending before the     Mark an  Xin the box if your business has passed the employment 
   period covered by this schedule.                                  test for the tax year ending before the period covered by this schedule 
                                                                     to verify that it is eligible to claim the QEZE credit. If not, stop; you 
If you meet these qualifications, you may use this schedule to       are not eligible for the QEZE credit. Do not file this schedule.
claim a credit for tax paid on qualifying purchases.
If you were certified by ESD on or after April 1, 2009, you must     Part 2 – Purchases eligible for credit by jurisdiction
have:                                                                Column C – Eligible purchases – Enter in Column C your 
                                                                     purchases eligible for credit on the appropriate jurisdiction line.
•  received your EZRC from ESD; and
•  passed the employment test for the tax year ending before the     If you were certified by ESD before April 1, 2009, use the 
   period covered by this schedule.                                  jurisdiction line for the locality where the purchase was made. 
                                                                     If a purchase was made in a local jurisdiction that is not listed, 
If you meet these qualifications, you may use this schedule to       enter the amount on either the New York State only 4% line or the 
claim a credit for tax paid on qualifying purchases, but only if     New York State/MCTD4  3%/8   line, as applicable.
the qualifying purchase is made in a locality that has elected to 
provide the credit. The following localities are currently eligible: If you were certified by ESD on or after April 1, 2009, credit is 
                                                                     only allowed if the jurisdiction has elected to provide this credit 
       Allegany County             Herkimer County                   (Allegany County, Cayuga County, city of Auburn, Erie County, 
       Cayuga County               Montgomery County                 Herkimer County, Montgomery County, and Niagara County). If the 
       Auburn (city)               Niagara County                    locality has not made this election, no credit of any taxes (State, 
       Erie County                                                   MCTD, and local) is allowed. Do not make any entries on either the 
If the locality where you made the purchase is not listed as         New York State only 4% line or theNew York State/MCTD 4  3%/8       line.
an eligible locality, no credit of any taxes (State, Metropolitan    Column E – Amount of sales and use tax credit – For each 
Commuter Transportation District (MCTD) or local) is available.      jurisdiction, multiply the amount in Column C by the tax rate in 
                                                                     Column D, and enter the resulting credit amount in Column E. After 
Specific instructions                                                entering information for all jurisdictions required, separately total 
Identification number and name – Print the sales tax                 Columns C and E. Include the column totals on Form ST-810 as 
identification number and legal name as shown on Form ST-810         instructed.
or on your business’s Certificate of Authority for sales and use tax.
                                                                     Filing this schedule
Part 1 – Verify eligibility                                          File a completed Form ST-810.1 and any other attachments with 
EZRC number – Print the empire zone certificate number from          Form ST-810 by the due date. Be sure to keep a copy of your 
your EZRC issued by ESD.                                             completed return for your records.

                                                                     Need help? and Privacy notification
        80100202210094                                               See Form ST-810-I, Instructions for Form ST-810.

                                                                                                            ST-810.1 (2/21)  Page 2 of 2






PDF file checksum: 390111989

(Plugin #1/8.13/12.0)