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File Free State Tax

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File Free State Tax

File free state tax 6. File free state tax   Tip Income Table of Contents Introduction Useful Items - You may want to see: Keeping a Daily Tip RecordElectronic tip record. File free state tax Reporting Tips to Your EmployerElectronic tip statement. File free state tax Final report. File free state tax Reporting Tips on Your Tax Return Allocated Tips Introduction This chapter is for employees who receive tips. File free state tax All tips you receive are income and are subject to federal income tax. File free state tax You must include in gross income all tips you receive directly, charged tips paid to you by your employer, and your share of any tips you receive under a tip-splitting or tip-pooling arrangement. File free state tax The value of noncash tips, such as tickets, passes, or other items of value, is also income and subject to tax. File free state tax Reporting your tip income correctly is not difficult. File free state tax You must do three things. File free state tax Keep a daily tip record. File free state tax Report tips to your employer. File free state tax Report all your tips on your income tax return. File free state tax  This chapter will explain these three things and show you what to do on your tax return if you have not done the first two. File free state tax This chapter will also show you how to treat allocated tips. File free state tax For information on special tip programs and agreements, see Publication 531. File free state tax Useful Items - You may want to see: Publication 531 Reporting Tip Income 1244 Employee's Daily Record of Tips and Report to Employer Form (and Instructions) 4137 Social Security and Medicare Tax on Unreported Tip Income 4070 Employee's Report of Tips to Employer Keeping a Daily Tip Record Why keep a daily tip record. File free state tax   You must keep a daily tip record so you can: Report your tips accurately to your employer, Report your tips accurately on your tax return, and Prove your tip income if your return is ever questioned. File free state tax How to keep a daily tip record. File free state tax   There are two ways to keep a daily tip record. File free state tax You can either: Write information about your tips in a tip diary, or Keep copies of documents that show your tips, such as restaurant bills and credit or debit card charge slips. File free state tax You should keep your daily tip record with your tax or other personal records. File free state tax You must keep your records for as long as they are important for administration of the federal tax law. File free state tax For information on how long to keep records, see How long to keep records in chapter 1. File free state tax    If you keep a tip diary, you can use Form 4070A, Employee's Daily Record of Tips. File free state tax To get Form 4070A, ask the Internal Revenue Service (IRS) or your employer for Publication 1244. File free state tax Also, Publication 1244 is available online at www. File free state tax irs. File free state tax gov/pub/irs-pdf/p1244. File free state tax pdf. File free state tax Publication 1244 includes a 1-year supply of Form 4070A. File free state tax Each day, write in the information asked for on the form. File free state tax   In addition to the information asked for on Form 4070A, you also need to keep a record of the date and value of any noncash tips you get, such as tickets, passes, or other items of value. File free state tax Although you do not report these tips to your employer, you must report them on your tax return. File free state tax   If you do not use Form 4070A, start your records by writing your name, your employer's name, and the name of the business (if it is different from your employer's name). File free state tax Then, each workday, write the date and the following information. File free state tax Cash tips you get directly from customers or from other employees. File free state tax Tips from credit and debit card charge customers that your employer pays you. File free state tax The value of any noncash tips you get, such as tickets, passes, or other items of value. File free state tax The amount of tips you paid out to other employees through tip pools or tip splitting, or other arrangements, and the names of the employees to whom you paid the tips. File free state tax Electronic tip record. File free state tax   You can use an electronic system provided by your employer to record your daily tips. File free state tax If you do, you must receive and keep a paper copy of this record. File free state tax Service charges. File free state tax    Do not write in your tip diary the amount of any service charge that your employer adds to a customer's bill and then pays to you and treats as wages. File free state tax This is part of your wages, not a tip. File free state tax See examples below. File free state tax Example 1. File free state tax Good Food Restaurant adds an 18% charge to the bill for parties of 6 or more customers. File free state tax Jane’s bill for food and beverages for her party of 8 includes an amount on the tip line equal to 18% of the charges for food and beverages, and the total includes this amount. File free state tax Because Jane did not have an unrestricted right to determine the amount on the “tip line,” the 18% charge is considered a service charge. File free state tax Do not include the 18% charge in your tip diary. File free state tax Service charges that are paid to you are considered wages, not tips. File free state tax Example 2. File free state tax Good Food Restaurant also includes sample calculations of tip amounts at the bottom of its bills for food and beverages provided to customers. File free state tax David’s bill includes a blank “tip line,” with sample tip calculations of 15%, 18%, and 20% of his charges for food and beverages at the bottom of the bill beneath the signature line. File free state tax Because David is free to enter any amount on the “tip line” or leave it blank, any amount he includes is considered a tip. File free state tax Be sure to include this amount in your tip diary. File free state tax Reporting Tips to Your Employer Why report tips to your employer. File free state tax   You must report tips to your employer so that: Your employer can withhold federal income tax and social security, Medicare, Additional Medicare, or railroad retirement taxes, Your employer can report the correct amount of your earnings to the Social Security Administration or Railroad Retirement Board (which affects your benefits when you retire or if you become disabled, or your family's benefits if you die), and You can avoid the penalty for not reporting tips to your employer (explained later). File free state tax What tips to report. File free state tax   Report to your employer only cash, check, and debit and credit card tips you receive. File free state tax   If your total tips for any 1 month from any one job are less than $20, do not report the tips for that month to that employer. File free state tax   If you participate in a tip-splitting or tip-pooling arrangement, report only the tips you receive and retain. File free state tax Do not report to your employer any portion of the tips you receive that you pass on to other employees. File free state tax However, you must report tips you receive from other employees. File free state tax    Do not report the value of any noncash tips, such as tickets or passes, to your employer. File free state tax You do not pay social security, Medicare, Additional Medicare or railroad retirement taxes on these tips. File free state tax How to report. File free state tax    If your employer does not give you any other way to report tips, you can use Form 4070. File free state tax Fill in the information asked for on the form, sign and date the form, and give it to your employer. File free state tax To get a 1-year supply of the form, ask the IRS or your employer for Publication 1244. File free state tax   If you do not use Form 4070, give your employer a statement with the following information. File free state tax Your name, address, and social security number. File free state tax Your employer's name, address, and business name (if it is different from your employer's name). File free state tax The month (or the dates of any shorter period) in which you received tips. File free state tax The total tips required to be reported for that period. File free state tax You must sign and date the statement. File free state tax Be sure to keep a copy with your tax or other personal records. File free state tax   Your employer may require you to report your tips more than once a month. File free state tax However, the statement cannot cover a period of more than 1 calendar month. File free state tax Electronic tip statement. File free state tax   Your employer can have you furnish your tip statements electronically. File free state tax When to report. File free state tax   Give your report for each month to your employer by the 10th of the next month. File free state tax If the 10th falls on a Saturday, Sunday, or legal holiday, give your employer the report by the next day that is not a Saturday, Sunday, or legal holiday. File free state tax Example. File free state tax You must report your tips received in September 2014 by October 10, 2014. File free state tax Final report. File free state tax   If your employment ends during the month, you can report your tips when your employment ends. File free state tax Penalty for not reporting tips. File free state tax   If you do not report tips to your employer as required, you may be subject to a penalty equal to 50% of the social security, Medicare, and Additional Medicare taxes or railroad retirement tax you owe on the unreported tips. File free state tax (For information about these taxes, see Reporting social security, Medicare, Additional Medicare, or railroad retirement taxes on tips not reported to your employer under Reporting Tips on Your Tax Return, later. File free state tax ) The penalty amount is in addition to the taxes you owe. File free state tax   You can avoid this penalty if you can show reasonable cause for not reporting the tips to your employer. File free state tax To do so, attach a statement to your return explaining why you did not report them. File free state tax Giving your employer money for taxes. File free state tax   Your regular pay may not be enough for your employer to withhold all the taxes you owe on your regular pay plus your reported tips. File free state tax If this happens, you can give your employer money until the close of the calendar year to pay the rest of the taxes. File free state tax   If you do not give your employer enough money, your employer will apply your regular pay and any money you give in the following order. File free state tax All taxes on your regular pay. File free state tax Social security, Medicare, and Additional Medicare taxes or railroad retirement taxes on your reported tips. File free state tax Federal, state, and local income taxes on your reported tips. File free state tax    Any taxes that remain unpaid can be collected by your employer from your next paycheck. File free state tax If withholding taxes remain uncollected at the end of the year, you may be subject to a penalty for underpayment of estimated taxes. File free state tax See Publication 505, Tax Withholding and Estimated Tax, for more information. File free state tax    Uncollected taxes. File free state tax You must report on your tax return any social security and Medicare taxes or railroad retirement tax that remained uncollected at the end of 2013. File free state tax These uncollected taxes will be shown on your 2013 Form W-2. File free state tax See Reporting uncollected social security, Medicare, or railroad retirement taxes on tips reported to your employer under Reporting Tips on Your Tax Return, later. File free state tax Reporting Tips on Your Tax Return How to report tips. File free state tax    Report your tips with your wages on Form 1040, line 7; Form 1040A, line 7; or Form 1040EZ, line 1. File free state tax What tips to report. File free state tax   You must report all tips you received in 2013 on your tax return, including both cash tips and noncash tips. File free state tax Any tips you reported to your employer for 2013 are included in the wages shown in box 1 of your Form W-2. File free state tax Add to the amount in box 1 only the tips you did not report to your employer. File free state tax    If you received $20 or more in cash and charge tips in a month and did not report all of those tips to your employer, see Reporting social security, Medicare, Additional Medicare, or railroad retirement taxes on tips not reported to your employer, later. File free state tax    If you did not keep a daily tip record as required and an amount is shown in box 8 of your Form W-2, see Allocated Tips, later. File free state tax   If you kept a daily tip record and reported tips to your employer as required under the rules explained earlier, add the following tips to the amount in box 1 of your Form W-2. File free state tax Cash and charge tips you received that totaled less than $20 for any month. File free state tax The value of noncash tips, such as tickets, passes, or other items of value. File free state tax Example. File free state tax Ben Smith began working at the Blue Ocean Restaurant (his only employer in 2013) on June 30 and received $10,000 in wages during the year. File free state tax Ben kept a daily tip record showing that his tips for June were $18 and his tips for the rest of the year totaled $7,000. File free state tax He was not required to report his June tips to his employer, but he reported all of the rest of his tips to his employer as required. File free state tax Ben's Form W-2 from Blue Ocean Restaurant shows $17,000 ($10,000 wages plus $7,000 reported tips) in box 1. File free state tax He adds the $18 unreported tips to that amount and reports $17,018 as wages on his tax return. File free state tax Reporting social security, Medicare, Additional Medicare, or railroad retirement taxes on tips not reported to your employer. File free state tax    If you received $20 or more in cash and charge tips in a month from any one job and did not report all of those tips to your employer, you must report the social security, Medicare, and Additional Medicare taxes on the unreported tips as additional tax on your return. File free state tax To report these taxes, you must file a return even if you would not otherwise have to file. File free state tax You must use Form 1040. File free state tax (You cannot file Form 1040EZ or Form 1040A. File free state tax )    Use Form 4137 to figure social security and Medicare taxes. File free state tax Enter the tax on your return as instructed, and attach the completed Form 4137 to your return. File free state tax Use Form 8959 to figure Additional Medicare Tax. File free state tax    If you are subject to the Railroad Retirement Tax Act, you cannot use Form 4137 to pay railroad retirement tax on unreported tips. File free state tax To get railroad retirement credit, you must report tips to your employer. File free state tax Reporting uncollected social security, Medicare, or railroad retirement taxes on tips reported to your employer. File free state tax   You may have uncollected taxes if your regular pay was not enough for your employer to withhold all the taxes you owe and you did not give your employer enough money to pay the rest of the taxes. File free state tax For more information, see Giving your employer money for taxes , under Reporting Tips to Your Employer, earlier. File free state tax   If your employer could not collect all the social security and Medicare taxes or railroad retirement tax you owe on tips reported for 2013, the uncollected taxes will be shown in box 12 of your Form W-2 (codes A and B). File free state tax You must report these amounts as additional tax on your return. File free state tax Unlike the uncollected portion of the regular (1. File free state tax 45%) Medicare tax, the uncollected Additional Medicare Tax is not reported in box 12 of Form W-2 with code B. File free state tax    To report these uncollected taxes, you must file a return even if you would not otherwise have to file. File free state tax You must report these taxes on Form 1040, line 60. File free state tax See the instructions for Form 1040, line 60. File free state tax (You cannot file Form 1040EZ or Form 1040A. File free state tax ) Allocated Tips If your employer allocated tips to you, they are shown separately in box 8 of your Form W-2. File free state tax They are not included in box 1 with your wages and reported tips. File free state tax If box 8 is blank, this discussion does not apply to you. File free state tax What are allocated tips. File free state tax   These are tips that your employer assigned to you in addition to the tips you reported to your employer for the year. File free state tax Your employer will have done this only if: You worked in an establishment (restaurant, cocktail lounge, or similar business) that must allocate tips to employees, and The tips you reported to your employer were less than your share of 8% of food and drink sales. File free state tax No income, social security, Medicare, Additional Medicare or railroad retirement taxes are withheld on allocated tips. File free state tax How were your allocated tips figured. File free state tax   The tips allocated to you are your share of an amount figured by subtracting the reported tips of all employees from 8% (or an approved lower rate) of food and drink sales (other than carryout sales and sales with a service charge of 10% or more). File free state tax Your share of that amount was figured using either a method provided by an employer-employee agreement or a method provided by IRS regulations based on employees' sales or hours worked. File free state tax For information about the exact allocation method used, ask your employer. File free state tax Must you report your allocated tips on your tax return. File free state tax   You must report all tips you received in 2013 on your tax return, including both cash tips and noncash tips. File free state tax Any tips you reported to your employer for 2013 are included in the wages shown in box 1 of your Form W-2. File free state tax Add to the amount in box 1 only the tips you did not report to your employer. File free state tax This should include any allocated tips shown in box 8 on your Form(s) W-2, unless you have adequate records to show that you received less tips in the year than the allocated figures. File free state tax   See What tips to report under Reporting Tips on Your Tax Return, and Keeping a Daily Tip Record , earlier. File free state tax How to report allocated tips. File free state tax   Report the amount in box 1 and the allocated tips in box 8 of your Form(s) W-2 as wages on Form 1040, line 7; Form 1040NR, line 8; or Form 1040NR-EZ, line 3. File free state tax (You cannot file Form 1040A or Form 1040EZ when you have allocated tips. File free state tax )    Because social security, Medicare, and Additional Medicare taxes were not withheld from the allocated tips, you must report those taxes as additional tax on your return. File free state tax Complete Form 4137, and include the allocated tips on line 1 of the form. File free state tax See Reporting social security, Medicare, Additional Medicare, or railroad retirement taxes on tips not reported to your employer under Reporting Tips on Your Tax Return, earlier. File free state tax Prev  Up  Next   Home   More Online Publications
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The File Free State Tax

File free state tax 18. File free state tax   Appendix This appendix contains models of the certificates, waivers, reports, and statements discussed in Part One. File free state tax Model Certificate A   STATEMENT OF SUBSEQUENT SELLER     1. File free state tax                 Name, address, and employer identification number of seller in subsequent sale             2. File free state tax                 Name, address, and employer identification number of the buyer in subsequent sale             3. File free state tax         Date and location of subsequent sale             4. File free state tax         Volume and type of taxable fuel sold               The undersigned seller (“Seller”) has received the copy of the first taxpayer's report provided with this statement in     connection with Seller's purchase of the taxable fuel described in this statement. File free state tax       Under penalties of perjury, Seller declares that Seller has examined this statement, including any accompanying     schedules and statements, and, to the best of Seller's knowledge and belief, they are true, correct and complete. File free state tax                   Signature and date signed                   Printed or typed name of person signing this report                   Title—   Model Certificate B   FIRST TAXPAYER'S REPORT   1. File free state tax                     First Taxpayer's name, address and employer identification number     2. File free state tax                     Name, address, and employer identification number of the buyer of the taxable fuel subject to tax     3. File free state tax           Date and location of removal, entry, or sale       4. File free state tax           Volume and type of taxable fuel removed, entered or sold     5. File free state tax Check type of taxable event:         Removal from refinery         Entry into United States         Bulk transfer from terminal by unregistered position holder       Bulk transfer not received at an approved terminal       Sale within the bulk transfer/terminal system       Removal at the terminal rack         Removal or sale by the blender                   6. File free state tax           Amount of federal excise tax paid on account of the removal, entry, or sale                   The undersigned taxpayer (“Taxpayer”) has not received, and will not claim, a credit with respect to, or a refund of, the tax     on the taxable fuel to which this form relates. File free state tax       Under penalties of perjury, Taxpayer declares that Taxpayer has examined this statement, including any accompanying     schedules and statements, and to the best of Taxpayer's knowledge and belief, they are true, correct and complete. File free state tax             Signature and date signed               Printed or typed name of person signing this report               Title     Model Certificate C   NOTIFICATION CERTIFICATE OF TAXABLE FUEL REGISTRANT                           Name, address, and employer identification number of person receiving certificate       The undersigned taxable registrant (“Registrant”) hereby certifies under penalties of perjury that Registrant is registered     by the Internal Revenue Service with registration number and that Registrant's registration has not     been revoked or suspended by the Internal Revenue Service. File free state tax                 Registrant understands that the fraudulent use of this certificate may subject Registrant and all parties making such     fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. File free state tax                       Signature and date signed                         Printed or typed name of person signing                         Title of person signing                         Name of Registrant                         Employer identification number                         Address of Registrant     Model Certificate D   CERTIFICATE OF PERSON BUYING GASOLINE BLENDSTOCKS FOR USE OTHER THAN IN THE PRODUCTION OF FINISHED GASOLINE     (To support tax-free sales (other than LUST) under section 4081 of the Internal Revenue Code. File free state tax )                 Name, address, and employer identification number of seller       The undersigned buyer (“Buyer”) hereby certifies the following under penalties of perjury:       The gasoline blendstocks to which this certificate relates will not be used to produce finished gasoline. File free state tax       This certificate applies to the following (complete as applicable):       If this is a single purchase certificate, check here and enter:     1. File free state tax Invoice or delivery ticket number       2. File free state tax (number of gallons) of(type of gasoline blendstocks)       If this is a certificate covering all purchases under a specified account or order number, check here and enter:     1. File free state tax Effective date       2. File free state tax Expiration date       (period not to exceed 1 year after the effective date)       3. File free state tax Type (or types) of gasoline blendstocks     4. File free state tax Buyer's account or order number         Buyer will not claim a credit or refund under section 6427(h) of the Internal Revenue Code for any gasoline blendstocks     covered by this certificate. File free state tax         Buyer will provide a new certificate to the seller if any information in this certificate changes. File free state tax       If Buyer resells the gasoline blendstocks to which this certificate relates, Buyer will be liable for tax unless Buyer obtains a     certificate from the purchaser stating that the gasoline blendstocks will not be used to produce finished gasoline and otherwise complies with the conditions of §48. File free state tax 4081-4(b)(3) of the Manufacturers and Retailers Excise Tax Regulations. File free state tax       Buyer understands that if Buyer violates the terms of this certificate, the Internal Revenue Service may withdraw Buyer's     right to provide a certificate. File free state tax       Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. File free state tax     In addition, the Internal Revenue Service has not notified Buyer that the right to provide a certificate has been withdrawn from a purchaser to which Buyer sells gasoline blendstocks tax free. File free state tax       Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making such fraudulent use     of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. File free state tax             Signature and date signed               Printed or typed name of person signing               Title of person signing               Name of Buyer               Employer identification number               Address of Buyer     Model Certificate G   CERTIFICATE OF REGISTERED FEEDSTOCK USER     (To support tax-free removals and entries (other than LUST) of kerosene under section 4082 of the Internal Revenue Code. File free state tax )         (Buyer) certifies the following under penalties of perjury:       Name of buyer         Buyer is a registered feedstock user with registration number . File free state tax Buyer's registration has not been revoked     or suspended. File free state tax         The kerosene to which this certificate applies will be used by Buyer for a feedstock purpose. File free state tax                 This certificate applies to percent of Buyer's purchases from (name, address, and employer     identification number of seller) as follows (complete as applicable):       1. File free state tax A single purchase on invoice or delivery ticket number . File free state tax                 2. File free state tax All purchases between (effective date) and (expiration date) (period not to exceed     one year after the effective date) under account or order number(s) . File free state tax If this certificate applies only to Buyer's     purchases for certain locations, check here and list the locations. File free state tax                                   If Buyer sells the kerosene to which this certificate relates, Buyer will be liable for tax on that sale. File free state tax                 Buyer will provide a new certificate to the seller if any information in this certificate changes. File free state tax                 If Buyer violates the terms of this certificate, the Internal Revenue Service may revoke the Buyer's registration. File free state tax                 Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making any fraudulent use of     this certificate to a fine or imprisonment, or both, together with the costs of prosecution. File free state tax             Printed or typed name of person signing               Title of person signing               Employer identification number               Address of Buyer               Signature and date signed     Model Certificate J   CERTIFICATE OF PERSON BUYING COMPRESSED NATURAL GAS (CNG) FOR A NONTAXABLE USE     (To support tax-free sales of CNG under section 4041 of the Internal Revenue Code. File free state tax )                                         Name, address, and employer identification number of seller                   (“Buyer”) certifies the following under penalties of perjury:     Name of buyer                     The CNG to which this certificate relates will be used in a nontaxable use. File free state tax       This certificate applies to the following (complete as applicable):               If this is a single purchase certificate, check here and enter:       1. File free state tax Invoice or delivery ticket number       2. File free state tax (Gasoline gallon equivalents)       If this is a certificate covering all purchases under a specified account or order number, check here and enter:         1. File free state tax Effective date         2. File free state tax Expiration date         (period not to exceed 1 year after the effective date)         3. File free state tax Buyer's account or order number       Buyer will not claim a credit or refund under section 6427 of the Internal Revenue Code for any CNG to which this certificate relates. File free state tax       Buyer will provide a new certificate to the seller if any information in this certificate changes. File free state tax       Buyer understands that if Buyer violates the terms of this certificate, the Internal Revenue Service may withdraw Buyer's     right to provide a certificate. File free state tax       Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. File free state tax     In addition, the Internal Revenue Service has not notified Buyer that the right to provide a certificate has been withdrawn     from a purchaser to which Buyer sells CNG tax free. File free state tax       Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making any fraudulent use     of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. File free state tax             Printed or typed name of person signing               Title of person signing             Employer identification number               Address of Buyer               Signature and date signed     Model Certificate K   CERTIFICATE OF PERSON BUYING KEROSENE FOR USE IN AVIATION FOR     COMMERCIAL AVIATION OR NONTAXABLE USE     (To support operator liability for tax on removals of kerosene for use in aviation directly into the fuel tank of an aircraft in commercial aviation pursuant to § 4081 of the Internal Revenue Code or to support a tax rate of zero under § 4041(c) pursuant to §§4041(c) and 4082. File free state tax )           Name, address, and employer identification number of position holder       The undersigned aircraft operator (“Buyer”) hereby certifies the following under the penalties of perjury:       The kerosene for use in aviation to which this certificate relates is purchased (check one): for     use on a farm for farming purposes; for use in foreign trade (reciprocal benefits required for foreign registered airlines); for use in certain helicopter and fixed-wing air ambulance uses; for use other than as a fuel in the propulsion engine of an aircraft; for the exclusive use of a qualified blood collector organization; for the exclusive use of a nonprofit educational organization; for the exclusive use of a state; for use in an aircraft owned by an aircraft museum; for use in military aircraft; or for use in commercial aviation (other than foreign trade). File free state tax       With respect to kerosene for use in aviation purchased after June 30, 2005, for use in commercial aviation     (other than foreign trade), Buyer's registration number is. File free state tax Buyer's registration has not been suspended or revoked by the Internal Revenue Service. File free state tax       This certificate applies to the following (complete as applicable):     This is a single purchase certificate:       1. File free state tax Invoice or delivery ticket number       2. File free state tax Number of gallons     This is a certificate covering all purchases under a specified account or order number:       1. File free state tax Effective date       2. File free state tax Expiration date (period not to exceed 1 year after the effective date)       3. File free state tax Buyer's account number       Buyer agrees to provide the person liable for tax with a new certificate if any information in this certificate changes. File free state tax       If the kerosene for use in aviation to which this certificate relates is being bought for use in commercial aviation     (other than foreign trade), Buyer is liable for tax on its use of the fuel and will pay that tax to the government. File free state tax       If Buyer sells or uses the kerosene for use in aviation to which this certificate relates for a use other than the use     stated above, Buyer will be liable for tax. File free state tax       Buyer understands that it must be prepared to establish by satisfactory evidence the purpose for which the     fuel purchased under this certificate was used. File free state tax     Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. File free state tax     If Buyer violates the terms of this certificate, the Internal Revenue Service may withdraw Buyer's right to provide a certificate. File free state tax       The fraudulent use of this certificate may subject Buyer and all parties making any fraudulent use of this certificate     to a fine or imprisonment, or both, together with the costs of prosecution. File free state tax           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Waiver L WAIVER FOR USE BY ULTIMATE PURCHASERS OF KEROSENE FOR CERTAIN USES IN AVIATION (To support vendor's claim for a credit or payment under § 6427(l)(4)(C)(i) of the Internal Revenue Code. File free state tax )               Name, Address, and Employer Identification Number of Ultimate Vendor     The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under penalties of perjury:     A. File free state tax The kerosene to which this waiver relates is purchased for — (check one):       1. File free state tax □ Use on a farm for farming purposes,       2. File free state tax □ Use in foreign trade (reciprocal benefits required for foreign registered airlines),       3. File free state tax □ Use in certain helicopter and fixed-wing air ambulance uses,       4. File free state tax □ The exclusive use of a qualified blood collector organization,       5. File free state tax □ The exclusive use of a nonprofit educational organization,       6. File free state tax □ Use in an aircraft owned by an aircraft museum,       7. File free state tax □ Use in military aircraft, or       8. File free state tax □ Use in commercial aviation (other than foreign trade). File free state tax     B. File free state tax This waiver applies to the following (complete as applicable):       This is a single purchase waiver:           1. File free state tax Invoice or delivery ticket number           2. File free state tax Number of gallons       This is a waiver covering all purchases under a specified account or order number:           1. File free state tax Effective date           2. File free state tax Expiration date (period not to exceed 1 year after the effective date)           3. File free state tax Buyer's account number       Buyer will provide a new waiver to the vendor if any information in this waiver changes. File free state tax       If Buyer uses the kerosene for use in aviation to which this waiver relates for a use other than the use stated above, Buyer will be liable for tax. File free state tax       Buyer understands that by signing this waiver, Buyer gives up its right to claim any credit or payment for the kerosene for use in aviation used in a nontaxable use. File free state tax       Buyer acknowledges that it has not and will not claim any credit or payment for the kerosene for use in aviation to which this waiver relates. File free state tax       Buyer understands that the fraudulent use of this waiver may subject Buyer and all parties making such fraudulent use of this waiver to a fine or imprisonment, or both, together with the costs of prosecution. File free state tax           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Certificate M   CERTIFICATE FOR STATE USE OR NONPROFIT EDUCATIONAL     ORGANIZATION USE     (To support vendor's claim for a credit or payment under § 6416(a)(4) of the Internal Revenue Code. File free state tax )                       Name, address, and employer identification number of ultimate vendor       The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under the penalties of perjury:       Buyer will use the gasoline or aviation gasoline to which this certificate relates (check one):     For the exclusive use of a state or local government; or     For the exclusive use of a nonprofit educational organization. File free state tax       This certificate applies to the following (complete as applicable):     This is a single purchase certificate:       1. File free state tax Invoice or delivery ticket number       2. File free state tax Number of gallons     This is a certificate covering all purchases under a specified account or order number:       1. File free state tax Effective date       2. File free state tax Expiration date (period not to exceed 1 year after the effective date)       3. File free state tax Buyer's account number       Buyer will provide a new certificate to the vendor if any information in this certificate changes. File free state tax       Buyer understands that by signing this certificate, Buyer gives up its right to claim any credit or payment for the gasoline or aviation gasoline to which this certificate relates. File free state tax       Buyer acknowledges that it has not and will not claim any credit or payment for the gasoline or aviation gasoline to which this certificate relates. File free state tax       Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. File free state tax           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Waiver N   WAIVER FOR USE BY ULTIMATE PURCHASERS OF DIESEL FUEL OR     KEROSENE USED IN INTERCITY BUS TRANSPORTATION     (To support vendor's claim for a credit or payment under § 6427 of the Internal Revenue Code. File free state tax )                       Name, address, and employer identification number of ultimate vendor       The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under the penalties of perjury:       The diesel fuel or kerosene to which this waiver relates is purchased for use in intercity bus transportation. File free state tax       This waiver applies to the following (complete as applicable):     This is a single purchase waiver:       1. File free state tax Invoice or delivery ticket number       2. File free state tax Number of gallons     This is a waiver covering all purchases under a specified account or order number:       1. File free state tax Effective date       2. File free state tax Expiration date (period not to exceed 1 year after the effective date)       3. File free state tax Buyer's account number       Buyer will provide a new waiver to the vendor if any information in this waiver changes. File free state tax       If Buyer uses the diesel fuel or kerosene to which this waiver relates for a use other than in intercity bus transportation, Buyer will be liable for tax. File free state tax       Buyer understands that by signing this waiver, Buyer gives up its right to claim any credit or payment for the diesel fuel or kerosene used in intercity bus transportation. File free state tax       Buyer acknowledges that it has not and will not claim any credit or payment for the diesel fuel or kerosene to which this waiver relates. File free state tax       Buyer understands that the fraudulent use of this waiver may subject Buyer and all parties making such fraudulent use of this waiver to a fine or imprisonment, or both, together with the costs of prosecution. File free state tax           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Certificate O   CERTIFICATE FOR BIODIESEL     Certificate Identification Number:     (To support a claim related to biodiesel or a biodiesel mixture under section 6426 of the Internal Revenue Code. File free state tax )     The undersigned biodiesel producer (“Producer”) hereby certifies the following under penalties of perjury:   1. File free state tax             Producer's name, address, and employer identification number (EIN)   2. File free state tax             Name, address, and EIN of person buying the biodiesel from Producer   3. File free state tax       Date and location of sale to buyer   4. File free state tax This certificate applies to gallons of biodiesel. File free state tax   5. File free state tax Producer certifies that the biodiesel to which this certificate relates is:       % Agri-biodiesel (derived solely from virgin oils)       % Biodiesel other than agri-biodiesel       This certificate applies to the following sale:       Invoice or delivery ticket number       Total number of gallons of biodiesel sold under that invoice or delivery ticket number (including biodiesel not covered by this certificate)       Total number of certificates issued for that invoice or delivery ticket number   6. File free state tax             Name, address, and employer identification number of reseller to whom certificate is issued (only in the case of certificates reissued to a reseller after the return of the original certificate)   7. File free state tax Original Certificate Identification Number (only in the case of certificates reissued to a reseller after return of the original certificate). File free state tax       Producer is registered as a biodiesel producer with registration number . File free state tax  Producer's registration has not been suspended or revoked by the Internal Revenue Service. File free state tax       Producer certifies that the biodiesel to which this certificate relates in monoalkyl esters of long chain fatty acids derived from plant or animal matter that meets the requirements of the American Society of Testing and Materials D6751 and the registration requirements for fuels and fuel additives established by EPA under section 211 of the Clean Air Act (42 U. File free state tax S. File free state tax C. File free state tax 7545). File free state tax       Producer understands that the fraudulent use of this certificate may subject Producer and all parties making any fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. File free state tax           Printed or typed name of person signing this certificate           Title of person signing           Signature and date signed   Model Certificate P CERTIFICATE OF STATE USE (To support vendor's claim for credit or payment under section 6427 of the Internal Revenue Code. File free state tax )               Name, Address, and Employer Identification Number of Vendor     The undersigned buyer (“Buyer”) hereby certifies the following under penalties of perjury:     A. File free state tax Buyer will use the diesel fuel or kerosene to which this certificate relates for the exclusive use of a state or local government, or the District of Columbia. File free state tax     B. File free state tax This certificate applies to the following (complete as applicable):       1. File free state tax   If this is a single purchase certificate, check here □ and enter:           a. File free state tax Invoice or delivery ticket number           b. File free state tax Number of gallons       2. File free state tax   If this is a certificate covering all purchases under a specified account or order number, check here □  and enter:           a. File free state tax Effective date           b. File free state tax Expiration date   (period not to exceed 1 year after effective date)           c. File free state tax Buyer's account or order number     ▪ Buyer will provide a new certificate to the vendor if any information in this certificate changes. File free state tax     ▪ If Buyer uses the diesel fuel or kerosene to which this certificate relates for a purpose other than stated in the certificate, Buyer will be liable for any tax. File free state tax     ▪ Buyer acknowledges that it has not and will not claim any credit or payment for the diesel fuel or kerosene to which this certificate relates. File free state tax     ▪ Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. File free state tax           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Certificate Q CERTIFICATE OF ULTIMATE PURCHASER OF KEROSENE FOR USE IN NONEXEMPT, NONCOMMERCIAL AVIATION (To support vendor's claim for credit or payment under section 6427(l)(4)(C)(ii) of the Internal Revenue Code. File free state tax )               Name, Address, and Employer Identification Number of Ultimate Vendor     The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under penalties of perjury:     A. File free state tax The kerosene to which this certificate relates is purchased for a nonexempt use in noncommercial aviation. File free state tax     B. File free state tax This certificate applies to the following (complete as applicable):       1. File free state tax   If this is a single purchase certificate, check here □ and enter:           a. File free state tax Invoice or delivery ticket number           b. File free state tax Number of gallons       2. File free state tax   This is a certificate covering all purchases under a specified account or order number:           a. File free state tax Effective date           b. File free state tax Expiration date   (period not to exceed 1 year after effective date)           c. File free state tax Buyer's account number     ▪ Buyer will provide a new certificate to the vendor if any information in this certificate changes. File free state tax     ▪ If Buyer uses the kerosene to which this certificate relates for a use other than the nontaxable use stated above, Buyer will be liable for tax. File free state tax     ▪ Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. File free state tax           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Certificate R CERTIFICATE OF BUYER OF TAXABLE FUEL FOR USE BY A STATE OR NONPROFIT EDUCATIONAL ORGANIZATION (To support credit card issuer's claim for credit, refund, or payment under section 6416(a)(4)(B) or section 6427(l)(5)(D) of the Internal Revenue Code. File free state tax )               Name, Address, and Employer Identification Number of Credit Card Issuer. File free state tax     The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under penalties of perjury:     A. File free state tax Buyer will use the taxable fuel to which this certificate relates for the exclusive use of a state; or     B. File free state tax Buyer will use the gasoline to which this certificate relates for the exclusive use of a nonprofit educational organization. File free state tax     C. File free state tax This certificate applies to all purchases made with the credit card identified below during the period specified:           a. File free state tax Effective date of certificate           b. File free state tax Expiration date of certificate   (period not to exceed 2 years after effective date)           c. File free state tax Buyer's account number     ▪ Buyer will provide a new certificate to the credit card issuer if any information in this certificate changes. File free state tax     ▪ Buyer understands that by signing this certificate, Buyer gives up its right to claim a credit or payment for the taxable fuel purchased with the credit card to which this certificate relates. File free state tax     ▪ Buyer acknowledges that it has not and will not claim any credit or payment for the taxable fuel purchased with the credit card to which this certificate relates. File free state tax     ▪ Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. File free state tax           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Statement S   STATEMENT OF BIODIESEL RESELLER     (To support a claim related to biodiesel or a biodiesel mixture under section 6426 of the Internal Revenue Code. File free state tax )     The undersigned biodiesel producer (“Reseller”) hereby certifies the following under penalties of perjury:   1. File free state tax                   Reseller's name, address, and employer identification number (EIN)   2. File free state tax                   Name, address, and EIN of Reseller's buyer   3. File free state tax       Date and location of sale to buyer   4. File free state tax Volume of biodiesel sold   5. File free state tax Certificate Identification Number on the Certificate for Biodiesel       Reseller has bought the biodiesel described in the accompanying Certificate for Biodiesel and Reseller has no reason to believe that any information in the certificate is false. File free state tax       Reseller has not been notified by the Internal Revenue Service that its right to provide a certificate or statement has been withdrawn. File free state tax       Reseller understands that the fraudulent use of this statement may subject Reseller and all parties making any fraudulent use of this statement to a fine or imprisonment, or both, together with the costs of prosecution. File free state tax           Printed or typed name of person signing this certificate           Title of person signing           Signature and date signed   Prev  Up  Next   Home   More Online Publications