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               Department of Taxation and Finance
               Business Purchaser’s Report of Sales and Use Tax ST-130
                                                                                                                                                                              (12/22)

This form is for use only by New York State businesses not registered or required to be registered for sales tax purposes. Do not 
use this form to report sales and use taxes due: (1) on business purchases if the business is registered, or required to be registered, 
for sales tax purposes; (2) on nonbusiness purchases; or (3) on the purchase of a motor vehicle, trailer, all-terrain vehicle, vessel, or 
snowmobile that must be registered or titled by the New York State Department of Motor Vehicles. See instructions.
                                                                                                                                                   For Tax Department use only
                                                                                                                                                   Tax jurisdiction code
 Purchaser’s name                                                    Employer identification number
                                                                                                                                                   Location code
 Purchaser’s address (number and street or rural route)
                                                                                                                                                   Taxable sales
 City                            County                                       State     ZIP code
                                                                                                                                                   Sales and use tax

  1a  Date item(s) or service(s) was first brought into New York State (see instructions) 
  1b  Description of item(s) or service(s) purchased (see instructions)

 1c   Seller’s name                                                    Address (number and street or rural route)

      City                                                                                            State                                          ZIP code

 2    Location of delivery or use, if different from purchaser’s address above (see instructions)
       Address (number and street or rural route)

       City                                            County                                         State                                          ZIP code

    3 Amount subject to sales or use tax (see instructions)  .....................................................................                 3
 4    Tax rate (see instructions)  ............................................................................................................... 4                          %
 5    Tax due (multiply amount on line 3 by rate on line 4)  ..........................................................................            5
 6    Allowable credit for tax paid (if any) to another jurisdiction (see instructions) .................................                          6
 7    Subtotal (subtract line 6 from line 5)  .................................................................................................    7
                                                        A – Taxable    B – Tax      C – Special taxes due
 Calculate special taxes (see instructions)                receipts    rate               (A x B)
 8    Supplemental tax on vapor products                               20%             8
 9    Special taxes on peer-to-peer car sharing                        6%              9
 10   Total special taxes (add lines 8 and 9 in column C)  ..........................................................................              10
 11   Total New York State sales or use taxes (add lines 7 and 10) .........................................................                       11
 12   Penalty and interest if you are filing or paying late (see instructions)  .............................................  12
  13  Total amount due (add lines 11 and 12)  ..........................................................................................           13
  14  Amount paid (enter your payment amount; this amount should match the amount due on line 13)  ..........                                      14
       Attach check or money order payable in U.S. funds to: New York State Sales Tax.
Certification: I certify that the above statements are true and correct, and I make these statements with the knowledge that willfully 
issuing a false or fraudulent document with the intent to evade tax may constitute a felony under New York State Tax Law, punishable by 
a substantial fine and a possible jail sentence. I also understand that the Tax Department is authorized to investigate the validity or the 
accuracy of any information entered on this document.
 Purchaser’s signature (give title and relationship)                                Date                 Telephone number of purchaser
                                                                                                         (                                           )
 Printed name of preparer (if other than purchaser)                                                   Preparer’s PTIN

 Preparer’s address                                                                             Preparer’s NYTPRIN                                                            Excl. code

 Preparer’s signature (if other than purchaser)                                                          Preparer’s telephone number
                                                                                                         (                                           )
                                                     See instructions for complete mailing information
      43000100220094






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