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Page 2 of 2 AU-12-I (12/10)
Form DTF-82, Application for a Qualified Empire Zone Enterprise (QEZE) the applicant is entitled to a credit or refund. We may request
Sales Tax Certification — For businesses certified by Empire State documentation to verify any schedule or summary that you submit.
Development before August 1, 2002; Form DTF-83, Application for a • The supporting documents should include the vendor’s name and
Qualified Empire Zone Enterprise (QEZE) Sales Tax Certification — For address. If they don’t, or if the transaction took place somewhere
businesses certified by Empire State Development on or after August 1, other than the vendor’s address, you must:
2002, and before April 1, 2005; or Form DTF-84, Application for a
Qualified Empire Zone Enterprise (QEZE) Sales Tax Certification — For — include the vendor’s name and location;
businesses certified by Empire State Development on or after April 1, — include the location where the transaction took place (generally,
2005, and before April 1, 2009). where you took title or possession); and
— include the invoices showing the tax you paid.
If you have more than one EZ location, use the effective date from your
first (earliest) Certificate of Eligibility to determine which worksheet you
need to file. Representative
If an outside individual or firm prepared the application (not the
You must complete and pass the employment test using your applicant or the owner, partner or an officer of the business listed
employment numbers for the tax year ending before the period covered as the applicant) the name and address should be included under
by this application to qualify for the credit or refund being claimed. Representative’s name and Representative’s mailing address.
Once you have completed the employment test worksheet for a tax The representative’s signature and the identification number of
year, attach a copy of that worksheet to any subsequent claim for credit the firm should be included under Representative’s signature and
or refund to which that employment test applies. Representative’s ID number. The representative must file a properly
If your credit or refund claim covers periods from more than one tax completed Form POA-1, Power of Attorney, authorizing him/her to act
year, you must complete and attach employment test worksheets for on the applicant’s behalf and to receive information pertaining to the
each tax year required. application for credit or refund. Form POA-1 is available on our Web site
(see Need help?).
Here’s an example:
A business was certified by ESD with an effective date of February When to file your application
15, 2008, on its Certificate of Eligibility. The business applied for and Generally, you must submit your application within three years from the
received QEZE sales tax certification from the Tax Department effective date the tax was payable to the Tax Department, or two years from the
October 1, 2008. The business files taxes on a calendar year basis. date the tax was paid, whichever is later. You may file this form only
At the end of December 2008, the business completed the employment test once each sales tax quarter.
for the 2008 tax year (January through December 2008) and determined that
it qualifies for QEZE sales tax benefits for 2009. Where to file your application
At the end of December 2009, the business completed the employment test Mail your completed application and all required substantiation and
for the 2009 tax year (January through December 2009) and determined that documentation to:
it qualifies for QEZE sales tax benefits for 2010. NYS TAX DEPARTMENT
TDAB – SALES TAX REFUNDS
In March 2010, the business files Form AU-12 to claim a refund of W A HARRIMAN CAMPUS
tax paid on qualifying purchases made during September through ALBANY NY 12227
December 2009 and for January through February 2010. When
filing Form AU-12 to claim the refund, it must complete and attach
Form AU-12.2 for the 2008 tax year to support its claim for a refund Need help?
for the September through December 2009 period, and Form AU-12.2
for the 2009 tax year to support its claim for a refund for the January
through February 2010 period. Internet access: www.tax.ny.gov
(for information, forms, and publications)
In June 2010, the business files Form AU-12 to claim a refund of tax
paid on qualifying purchases made during March through May 2010.
When filing Form AU-12 to claim the refund, it must attach a copy of its Sales Tax Information Center: (518) 485-2889
Form AU-12.2 for the 2009 tax year to support the refund claimed. To order forms and publications: (518) 457-5431
Documentation Text Telephone (TTY) Hotline
• Explain the basis for the credit or refund claim in detail and send (for persons with hearing and
legible copies of all supporting documents (for example: invoices, speech disabilities using a TTY): (518) 485-5082
receipts, proof of payment of tax, etc.).
• Your documents must be in a format that allows the Tax Department
to determine the correct jurisdiction and amount for each credit Privacy notification
or refund claimed. Cash receipts, register tapes, or other forms of The Commissioner of Taxation and Finance may collect and maintain
receipts or invoices that don’t identify the purchaser may not be personal information pursuant to the New York State Tax Law, including
accepted. but not limited to, sections 5-a, 171, 171-a, 287, 308, 429, 475, 505,
• Your documents must contain the address of the business receiving 697, 1096, 1142, and 1415 of that Law; and may require disclosure of
the property or services. social security numbers pursuant to 42 USC 405(c)(2)(C)(i).
• If your form is incomplete, or if you don’t provide necessary This information will be used to determine and administer tax liabilities
supporting documents, we may deny your application. and, when authorized by law, for certain tax offset and exchange of tax
• If the invoices and credit memoranda to be submitted are information programs as well as for any other lawful purpose.
voluminous, submit a schedule or a summary in table form. The Information concerning quarterly wages paid to employees is provided
schedule or summary should contain all pertinent information to certain state agencies for purposes of fraud prevention, support
concerning these documents, such as invoice number, date of enforcement, evaluation of the effectiveness of certain employment and
invoice, name of purchaser or supplier, item sold or purchased, training programs and other purposes authorized by law.
amount of invoice excluding tax, amount of tax billed, taxing Failure to provide the required information may subject you to civil or
jurisdiction where sale or purchase was made, and the reason criminal penalties, or both, under the Tax Law.
This information is maintained by the Manager of Document
Management, NYS Tax Department, W A Harriman Campus, Albany NY
12227; telephone (518) 457-5181.
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