- 2 -
|
Page 2 of 2 FT-1012 (11/18)
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, complete, and correct, and that no material information has been omitted. I make these statements
with the knowledge that willfully providing false or fraudulent information with the intent to evade tax may constitute a felony or other crime under New York
State Law, punishable by a substantial fine and possible jail sentence. I understand that the vendor is required to collect such applicable taxes from me unless
I properly furnish this certificate to the vendor and that the vendor must retain this certificate and make it available to the Tax Department upon request. I also
understand that the Tax Department is authorized to investigate the validity and accuracy of any information entered on this document.
Signature of purchaser or authorized representative Title Date
Instructions
General information Dyed diesel motor fuel means diesel motor fuel which has been dyed in
This certificate can be used to claim exemption from the taxes (the accordance with and for the purpose of complying with the provisions of
petroleum business tax, diesel motor fuel tax, and sales and use tax) 26 USC 4082(a).
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
This certificate may not be used to purchase fuel for use in farm for use in the operation of a motor vehicle engine. This product is
production; use Form FT-1004, Certificate for Purchases of sometimes used for the production of electric power, space heating,
Non-Highway Diesel Motor Fuel or Residual Petroleum Product for vessel bunkering, and other industrial purposes.
Farmers and Commercial Horse Boarding Operations.
Directly means the fuel must, during the production phase of a Need help?
process, operate exempt production machinery or equipment, or create
conditions necessary for production, or perform an actual part of the
production process. Visit our website at www.tax.ny.gov
• get information and manage your taxes online
Exclusively means that all of the fuel is used entirely (100%) in the
production process. • check for new online services and features
Production includes the production line of the plant, starting with the Telephone assistance
handling and storage of raw materials at the plant site and continuing
through the last step of production where the product is finished and Miscellaneous Tax Information Center: 518-457-5735
packaged for sale. To order forms and publications: 518-457-5431
Manufacturing means the production of tangible personal property that Text Telephone (TTY) or TDD Dial 7-1-1 for the
has a different identity from its ingredients. equipment users New York Relay Service
Processing means the performance of any service on tangible personal
property that changes the nature, shape, or form of the property.
Assembly means the coupling or the uniting of parts or materials as
a manufacturing process or a step in the manufacturing process that
results in a new product.
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.
|