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                             Department of Taxation and Finance
                             Claim for Refund/Reimbursement of Taxes Paid on                                                     AU‑631
                                                                                                                                                       (5/17)
                             Fuel Used in a Vessel Engaged in Commercial Fishing
                             Tax Law – Articles 12‑A, 13‑A, 28, and 29

 Employer identification number (EIN) or social security number (SSN)  Business telephone number    For tax period:
                                                                     (     )                        Beginning                    Ending
 Legal name
                                                                                                                     For office use only
 DBA (doing business as) name (if different from legal name)                                        Total approved

 Street address                                                                                     Audited by                          Date

 City, state, and ZIP code                                                                          Approved by                         Date

 Name of vessel                                                                                     Approved by                         Date

                                                                          Column A                     Column B                  Column C
Computation of Refund/Reimbursement                                  Gallons (from schedules)       Tax paid (from schedules)           Totals

  1  Motor fuel excise tax paid..............................      1

  2 Diesel motor fuel excise tax paid...................           2
  3 Total Article 12‑A reimbursement requested
     (add lines 1 and 2, Column B)  ........................       3

  4 Petroleum business tax paid (motor fuel) ......                4
  5 Petroleum business tax paid 
      (diesel motor fuel) ......................................   5
  6 Total Article 13‑A reimbursement requested
     (add lines 4 and 5, Column B)  ........................       6

  7 State and local sales tax (motor fuel) ............            7

  8 State and local sales tax (diesel motor fuel)..                8
  9 Total state and local sales tax refund 
     requested (add lines 7 and 8, Column B)  .......              9
 10  Total refund/reimbursement requested  
     (add lines 3, 6 and 9, Column C)  ....................        10

     Third‑party          Print designee’s name                                    Designee’s phone number                       Personal identification
  designee? (see instr.)                                                           (    )                                               number (PIN)
 Yes          No          E‑mail:

Certification: I certify that all information provided on the claim is true, correct and complete, and that I am authorized by the taxpayer 
to file it. I make these statements with the knowledge that willfully providing false or fraudulent information with this document may 
constitute a felony or other crime under New York State Law, punishable by a substantial fine and a possible jail sentence. I understand 
that the Tax Department is authorized to investigate the accuracy of any information entered on this claim.

              Printed name of authorized person                      Signature of authorized person                Official title
 Authorized
  person        E‑mail address of authorized person                                                 Telephone number             Date
                                                                                                    (          )
    Paid        Firm’s name (or yours if self-employed)                                             Firm’s EIN                   Preparer’s PTIN or SSN
  preparer      Signature of individual preparing this application   Address                                    City             State  ZIP code
    use
    only        E-mail address of individual preparing this application                       Preparer’s NYTPRIN     or Excl. code  Date
  (see instr.)

                 Mail to:  NYS TAX DEPARTMENT, FUEL TAX REFUND UNIT, PO BOX 15197, ALBANY NY 12212-5197
                                 If not using U.S. Mail, see Publication 55, Designated Private Delivery Services.



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Page 2 of 4  AU‑631 (5/17)   Schedule A - Motor Fuel Purchases
                                      (Attach additional sheets if necessary.)
   Date of                   Seller’s                              Invoice            Number of    Excise    Petroleum business                   Sales
 purchase          Name               City              County     number             gallons      tax paid  tax paid                             tax paid

 11  Total gallons purchased (enter here and on lines 1, 4, and 7, Column A)  ........

 12  Total excise tax paid/reimbursement claimed (enter here and on line 1, Column B)  ..........  

 13 Total petroleum business tax paid/reimbursement claimed (enter here and on line 4, Column B)  ...........

 14 Total state and local sales tax paid/refund claimed (enter here and on line 7, Column B)  ..................................................  



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                             Schedule B - Diesel Motor Fuel Purchases                                        AU‑631 (5/17)                        Page 3 of 4
                                      (Attach additional sheets if necessary.)
   Date of                   Seller’s                              Invoice            Number of    Excise    Petroleum business                   Sales
 purchase  Name                       City              County     number             gallons      tax paid  tax paid                             tax paid

 15  Total gallons purchased (enter here and on lines 2, 5, and 8, Column A)  ........

 16  Total excise tax paid/reimbursement claimed (enter here and on line 2, Column B)  ..........  

 17 Total petroleum business tax paid/reimbursement claimed (enter here and on line 5, Column B)  ...........

 18 Total state and local sales tax paid/refund claimed (enter here and on line 8, Column B)  ..................................................  



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Page 4 of 4  AU‑631 (5/17)

                                                                  Instructions
Who may use this form                                                       You are not authorizing the designee to receive your refund, bind you 
Any person who is a commercial fisherman, defined as a person               to anything (including any additional tax liability), or otherwise represent 
licensed by an appropriate federal or state agency for the purpose of       you before the Tax Department. If you want someone to represent you or 
engaging in the commercial harvesting of fish and who is engaged in         perform services for you beyond the scope of the third-party designee, 
the business of harvesting fish for sale, must use this form to claim a     you must designate the person using a power of attorney (for example, 
refund/reimbursement of the motor fuel or diesel motor fuel excise tax,     Form POA-1, Power of Attorney).
the petroleum business tax, and the state and local sales tax on the 
fuel purchased for use in the operation of a commercial fishing vessel      Paid preparer’s signature
engaged in the harvesting of fish for sale.                                 If you pay someone to prepare your form, the paid preparer must also 
                                                                            sign it and fill in the other blanks in the paid preparer’s area of your form. 
When to File                                                                A person who prepares your form and does not charge you should not fill 
A claim for refund/reimbursement should be filed for a full monthly         in the paid preparer’s area.
period; however, a claimant may include more than one month in a            Paid preparer’s responsibilities – Under the law, all paid preparers 
single claim. Each monthly period should begin on the first and end on      must sign and complete the paid preparer section of the form. Paid 
the last day of a calendar month.                                           preparers may be subject to civil and/or criminal sanctions if they fail to 
Claims for reimbursement of the motor fuel or diesel motor fuel excise      complete this section in full.
tax and the petroleum business tax must be filed within three years from    When completing this section, enter your New York tax preparer 
the date of purchase. Claims for refund of the New York State and local     registration identification number (NYTPRIN) if you are required to have 
sales tax should be filed within three years from the date the tax was      one. If you are not required to have a NYTPRIN, enter in the NYTPRIN 
due.                                                                        excl. code box one of the specified 2-digit codes listed below that 
                                                                            indicates why you are exempt from the registration requirement. You 
General Instructions                                                        must enter a NYTPRIN or an exclusion code. Also, you must enter your 
In order to expedite the processing of a refund/reimbursement claim, a      federal preparer tax identification number (PTIN) if you have one; if not, 
claimant must furnish the necessary substantiation and adhere to the        you must enter your social security number.
following procedures:
•  You must complete the entire claim form, including schedules A and B.    Code Exemption type               Code Exemption type
 Attach a worksheet, if necessary, and include adding machine tapes if      01  Attorney                      02   Employee of attorney
 the worksheet is not computer-generated.
•  You must furnish legible copies of purchase invoices showing each        03  CPA                           04   Employee of CPA
 tax (motor fuel and/or diesel motor fuel excise tax, petroleum business    05  PA (Public Accountant)        06   Employee of PA
 tax, and sales tax) listed separately.
                                                                            07  Enrolled agent                08   Employee of enrolled agent
•  You must include a copy of your current United States Coast Guard 
 documentation, if your vessel is required to be documented, and            09  Volunteer tax preparer        10   Employee of business 
 with the first claim each calendar year include a copy of your current                                            preparing that business’ 
 Federal Fisheries Permit and/or your current license issued by the                                                return
 New York State Department of Environmental Conservation.
•  You must include the telephone number for your business in case we       See our website for more information about the tax preparer registration 
 need to contact you concerning your refund/reimbursement.                  requirements.
Additional documentation may be requested by the Tax Department 
upon review of the refund/reimbursement claim submitted.                    Privacy notification
                                                                            New York State Law requires all government agencies that maintain a 
Line instructions                                                           system of records to provide notification of the legal authority for any 
                                                                            request for personal information, the principal purpose(s) for which the 
Lines 1 and 2 – Enter the number of gallons and applicable excise tax       information is to be collected, and where it will be maintained. To view 
paid from Schedule A and Schedule B.                                        this information, visit our website, or, if you do not have Internet access, 
Lines 4 and 5 – Enter the number of gallons and applicable petroleum        call and request Publication 54, Privacy Notification. See Need help? for 
business tax paid from Schedule A and Schedule B.                           the Web address and telephone number.
Lines 7 and 8 – Enter the number of gallons and applicable state and 
local sales tax paid from Schedule A and Schedule B.
                                                                            Need help?
Schedules A and B
Complete all columns of Schedules A and B. Enter information                          Visit our website at www.tax.ny.gov
for those purchases for which a refund/reimbursement is claimed.                        (for information, forms, and online services)
Attach copies of all invoices listed. Attach additional sheets if 
necessary. Be sure to total the Number of gallons, Excise tax paid,             Miscellaneous Tax Information Center:            (518) 457-5735
Petroleum business tax paid and Sales tax paid columns. The totals of 
these columns must be carried to the front page as indicated.                   To order forms and publications:                 (518) 457-5431

Third‑party designee                                                            Text Telephone (TTY) Hotline
                                                                                      (for persons with hearing and
If you want to authorize another individual (third-party designee) to             speech disabilities using a TTY):              (518) 485-5082
discuss this tax claim with the New York State Tax Department, mark an 
X in the Yes box in the third-party designee area of your claim. Also print 
the designee’s name, phone number, e-mail address, and any five-digit 
number the designee chooses as his or her personal identification 
number (PIN). For more information about the third-party designee, see 
Form PT-350-I, Instructions for Form PT-350.






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