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                             New York State Department of Taxation and Finance

                             Instructions for Form AU-12                                                                    AU-12-I
                                                                                                                                                   (12/10)
                             Application for Credit or Refund of Sales or Use Tax — 
                             Qualified Empire Zone Enterprise (QEZE)

General information                                                           Claiming credit on a sales tax return
Use Form AU-12 to apply for the QEZE credit or refund provided by             If you’re registered for New York State sales tax, you may report your 
Tax Law section 1119(d), effective for qualifying purchases made on or        QEZE credit on your sales tax return (Schedule W) to offset sales tax 
after September 1, 2009.                                                      due. 
Use Form AU-11, Application for Credit or Refund of Sales or Use Tax,         •  If you’re applying part of your claim as a credit on Schedule W and 
to claim                                                                         requesting the balance as a refund, you must state these amounts 
                                                                                 separately in the applicable boxes.
•  a credit or refund based on purchases made before September 1, 
2009, and                                                                     •  If the sales tax due on your return is less than the credit claimed, you  
                                                                                 must claim the remaining balance as a refund. You may not carry the  
•  a credit or refund under Tax Law section 1119(a)(6) for tax paid on          balance forward on future returns.  
building materials used in construction, expansion, or rehabilitation of 
real property located in an empire zone (EZ). 
                                                                              Basis for claim
For more information, see TSB-M-09(12)S,Changes to Qualified                  Mark an  Xin each appropriate box. 
Empire Zone Enterprise (QEZE) Program (Articles 28 and 29) - Effective 
September 1, 2009.                                                            A — The property or service must be directly and predominantly (at 
                                                                              least 50%) used or consumed by the QEZE in an EZ in which the 
You must attach all required substantiation and documentation or your         QEZE has qualified for benefits. The credit or refund does not apply to 
claim will not be processed. This includes:                                   purchases of taxable food and drink (items such as sandwiches, heated 
•  copy of the Certificate of Eligibility issued by Empire State              food, heated drink, or restaurant meals). The credit or refund also does 
Development (ESD);                                                            not apply to rent for hotel occupancy or charges for admission to a 
•  copy of the Empire Zone Retention Certificate (EZRC) issued by ESD;        place of amusement.
•  employment test worksheet:                                                 B — The utility services must be directly and exclusively (100%) used 
  —  Form AU-12.1, Employment Test for Businesses Certified by                or consumed by the QEZE in an EZ in which the QEZE has qualified for 
     Empire State Development (ESD) Before April 1, 2005                      benefits. This includes gas, electricity, refrigeration, and steam; and gas, 
                                                                              electric, refrigeration, and steam services of whatever nature.
  —  Form AU-12.2, Employment Test for Businesses Certified by Empire 
     State Development (ESD) On or After April 1, 2005, and Before April 1,   C — The telephony and telegraphy, telephone and telegraph services, 
     2009                                                                     or telephone answering services must be delivered and billed to the 
  —  Form AU-12.3, Employment Test for Businesses Certified by                QEZE at an address in an EZ in which the QEZE has qualified for 
     Empire State Development (ESD) On or After April 1, 2009                 benefits.
•  documentation regarding your claim as described in Basis for claim         D — The vehicle must be predominantly (at least 50%) used by 
•  invoices, receipts, proof of payment of tax, etc.                          the QEZE in an EZ in which the QEZE has qualified for benefits. 
                                                                              Predominant use in EZs will occur if any one of the following conditions 
Who may file                                                                  is met:
You may apply for a credit or refund of sales tax paid on qualifying          •  At least 50% of the vehicle’s use is exclusively in such zones.
purchases if you are a QEZE for sales and use tax purposes and you            •  At least 50% of the vehicle’s use is in activities originating or 
meet the criteria below.                                                         terminating in such zones.
If you were certified by ESD before April 1, 2009, you must have:             •  At least 50% of the vehicle’s use is a combination of use exclusively 
                                                                                 in such zones and in activities originating or terminating in such 
•  applied for and received Form DTF-81, Qualified Empire Zone                   zones.
Enterprise (QEZE) Sales Tax Certification;
•  received your EZRC from ESD; and                                           The QEZE may choose to compute the usage of the vehicle based 
                                                                              on either hours of use or miles traveled. This QEZE credit or refund 
•  passed the employment test for the tax year ending before the period       pertaining to motor vehicles also applies to the special taxes imposed 
covered by this claim.                                                        under Tax Law Article 28-A on passenger car rentals.
If you meet these qualifications, you may use this form to claim a credit     E — Certain tangible personal property related to a motor vehicle; the 
or refund for tax paid on qualifying purchases.                               motor vehicle must be used predominantly (at least 50%) by a QEZE 
If you were certified by ESD on or after April 1, 2009, you must have:        in an EZ in which the QEZE has qualified for benefits, as described 
                                                                              in box D. Examples of tangible personal property related to a motor 
•  received your EZRC from ESD; and                                           vehicle include a battery, an engine, engine components, a muffler, tires 
•  passed the employment test for the tax year ending before the period       and similar tangible personal property used in or on a motor vehicle.
covered by this claim.
If you meet these qualifications, you may use Form AU-12                      Employment test
to claim a credit or refund for tax paid on qualifying purchases,             You must pass an employment test at the end of every tax year 
but only if the qualifying purchase is made in a locality that has elected    (calendar or fiscal) to determine if you qualify for QEZE sales tax 
to provide the credit. For more information, see Publication 718-QZ,          benefits for the next tax year. The effective date from your Certificate 
Qualified Empire Zone Enterprise (QEZE) Sales and Use Tax Refund              of Eligibility (issued by ESD) determines which worksheet you need to 
Rates.                                                                        include. 
                                                                              •  Form AU-12.1, if you were certified by ESD before April 1, 2005
Applicant information                                                         •  Form AU-12.2, if you were certified by ESD on or after April 1, 2005, 
Enter the address for the EZ location where the items or services are            and before April 1, 2009
being used. This may or may not be the main, or primary, address of the       •  Form AU-12.3, if you were certified by ESD on or after April 1, 2009
business.
                                                                              If you were certified before April 1, 2009, complete the employment test 
If you are requesting a credit or refund for qualifying purchases made        using your base period information from your application for QEZE sales 
for more than one EZ location, attach a list containing the addresses of      tax certification filed with the Tax Department (Form DTF-80, Application 
all EZ locations included in this claim.                                      for a Qualified Empire Zone Enterprise (QEZE) Sales Tax Certification; 



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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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