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Free File State Tax

Free file state tax 6. Free file state tax   Insurance Table of Contents What's New Introduction Topics - This chapter discusses: Useful Items - You may want to see: Deductible PremiumsSelf-Employed Health Insurance Deduction Nondeductible Premiums Capitalized Premiums When To Deduct Premiums What's New Retiree drug subsidy. Free file state tax  Beginning in 2013, sponsors of certain qualified retiree prescription drug plans must account for the subsidy received by reducing the amount of qualified retiree prescription drug plans expense by the subsidy received (taking into account the taxpayer's accounting method). Free file state tax For more information, see the retiree drug subsidy frequently asked questions on IRS. Free file state tax gov. Free file state tax Introduction You generally can deduct the ordinary and necessary cost of insurance as a business expense if it is for your trade, business, or profession. Free file state tax However, you may have to capitalize certain insurance costs under the uniform capitalization rules. Free file state tax For more information, see Capitalized Premiums , later. Free file state tax Topics - This chapter discusses: Deductible premiums Nondeductible premiums Capitalized premiums When to deduct premiums Useful Items - You may want to see: Publication 15-B Employer's Tax Guide to Fringe Benefits 525 Taxable and Nontaxable Income 538 Accounting Periods and Methods 547 Casualties, Disasters, and Thefts Form (and Instructions) 1040 U. Free file state tax S. Free file state tax Individual Income Tax Return See chapter 12 for information about getting publications and forms. Free file state tax Deductible Premiums You generally can deduct premiums you pay for the following kinds of insurance related to your trade or business. Free file state tax Insurance that covers fire, storm, theft, accident, or similar losses. Free file state tax Credit insurance that covers losses from business bad debts. Free file state tax Group hospitalization and medical insurance for employees, including long-term care insurance. Free file state tax If a partnership pays accident and health insurance premiums for its partners, it generally can deduct them as guaranteed payments to partners. Free file state tax If an S corporation pays accident and health insurance premiums for its more-than-2% shareholder-employees, it generally can deduct them, but must also include them in the shareholder's wages subject to federal income tax withholding. Free file state tax See Publication 15-B. Free file state tax Liability insurance. Free file state tax Malpractice insurance that covers your personal liability for professional negligence resulting in injury or damage to patients or clients. Free file state tax Workers' compensation insurance set by state law that covers any claims for bodily injuries or job-related diseases suffered by employees in your business, regardless of fault. Free file state tax If a partnership pays workers' compensation premiums for its partners, it generally can deduct them as guaranteed payments to partners. Free file state tax If an S corporation pays workers' compensation premiums for its more-than-2% shareholder-employees, it generally can deduct them, but must also include them in the shareholder's wages. Free file state tax Contributions to a state unemployment insurance fund are deductible as taxes if they are considered taxes under state law. Free file state tax Overhead insurance that pays for business overhead expenses you have during long periods of disability caused by your injury or sickness. Free file state tax Car and other vehicle insurance that covers vehicles used in your business for liability, damages, and other losses. Free file state tax If you operate a vehicle partly for personal use, deduct only the part of the insurance premium that applies to the business use of the vehicle. Free file state tax If you use the standard mileage rate to figure your car expenses, you cannot deduct any car insurance premiums. Free file state tax Life insurance covering your officers and employees if you are not directly or indirectly a beneficiary under the contract. Free file state tax Business interruption insurance that pays for lost profits if your business is shut down due to a fire or other cause. Free file state tax Self-Employed Health Insurance Deduction You may be able to deduct premiums paid for medical and dental insurance and qualified long-term care insurance for yourself, your spouse, and your dependents. Free file state tax The insurance can also cover your child who was under age 27 at the end of 2013, even if the child was not your dependent. Free file state tax A child includes your son, daughter, stepchild, adopted child, or foster child. Free file state tax A foster child is any child placed with you by an authorized placement agency or by judgment, decree, or other order of any court of competent jurisdiction. Free file state tax One of the following statements must be true. Free file state tax You were self-employed and had a net profit for the year reported on Schedule C (Form 1040), Profit or Loss From Business; Schedule C-EZ (Form 1040), Net Profit From Business; or Schedule F (Form 1040), Profit or Loss From Farming. Free file state tax You were a partner with net earnings from self-employment for the year reported on Schedule K-1 (Form 1065), Partner's Share of Income, Deductions, Credits, etc. Free file state tax , box 14, code A. Free file state tax You used one of the optional methods to figure your net earnings from self-employment on Schedule SE. Free file state tax You received wages in 2013 from an S corporation in which you were a more-than-2% shareholder. Free file state tax Health insurance premiums paid or reimbursed by the S corporation are shown as wages on Form W-2, Wage and Tax Statement. Free file state tax The insurance plan must be established, or considered to be established as discussed in the following bullets, under your business. Free file state tax For self-employed individuals filing a Schedule C, C-EZ, or F, a policy can be either in the name of the business or in the name of the individual. Free file state tax For partners, a policy can be either in the name of the partnership or in the name of the partner. Free file state tax You can either pay the premiums yourself or your partnership can pay them and report the premium amounts on Schedule K-1 (Form 1065) as guaranteed payments to be included in your gross income. Free file state tax However, if the policy is in your name and you pay the premiums yourself, the partnership must reimburse you and report the premium amounts on Schedule K-1 (Form 1065) as guaranteed payments to be included in your gross income. Free file state tax Otherwise, the insurance plan will not be considered to be established under your business. Free file state tax For more-than-2% shareholders, a policy can be either in the name of the S corporation or in the name of the shareholder. Free file state tax You can either pay the premiums yourself or your S corporation can pay them and report the premium amounts on Form W-2 as wages to be included in your gross income. Free file state tax However, if the policy is in your name and you pay the premiums yourself, the S corporation must reimburse you and report the premium amounts on Form W-2 as wages to be included in your gross income. Free file state tax Otherwise, the insurance plan will not be considered to be established under your business. Free file state tax Medicare premiums you voluntarily pay to obtain insurance in your name that is similar to qualifying private health insurance can be used to figure the deduction. Free file state tax If you previously filed returns without using Medicare premiums to figure the deduction, you can file timely amended returns to refigure the deduction. Free file state tax For more information, see Form 1040X, Amended U. Free file state tax S. Free file state tax Individual Income Tax Return. Free file state tax Amounts paid for health insurance coverage from retirement plan distributions that were nontaxable because you are a retired public safety officer cannot be used to figure the deduction. Free file state tax Take the deduction on Form 1040, line 29. Free file state tax Qualified long-term care insurance. Free file state tax   You can include premiums paid on a qualified long-term care insurance contract when figuring your deduction. Free file state tax But, for each person covered, you can include only the smaller of the following amounts. Free file state tax The amount paid for that person. Free file state tax The amount shown below. Free file state tax Use the person's age at the end of the tax year. Free file state tax Age 40 or younger–$360 Age 41 to 50–$680 Age 51 to 60–$1,360 Age 61 to 70–$3,640 Age 71 or older–$4,550 Qualified long-term care insurance contract. Free file state tax   A qualified long-term care insurance contract is an insurance contract that only provides coverage of qualified long-term care services. Free file state tax The contract must meet all the following requirements. Free file state tax It must be guaranteed renewable. Free file state tax It must provide that refunds, other than refunds on the death of the insured or complete surrender or cancellation of the contract, and dividends under the contract may be used only to reduce future premiums or increase future benefits. Free file state tax It must not provide for a cash surrender value or other money that can be paid, assigned, pledged, or borrowed. Free file state tax It generally must not pay or reimburse expenses incurred for services or items that would be reimbursed under Medicare, except where Medicare is a secondary payer or the contract makes per diem or other periodic payments without regard to expenses. Free file state tax Qualified long-term care services. Free file state tax   Qualified long-term care services are: Necessary diagnostic, preventive, therapeutic, curing, treating, mitigating, and rehabilitative services, and Maintenance or personal care services. Free file state tax The services must be required by a chronically ill individual and prescribed by a licensed health care practitioner. Free file state tax Worksheet 6-A. Free file state tax Self-Employed Health Insurance Deduction Worksheet Note. Free file state tax Use a separate worksheet for each trade or business under which an insurance plan is established. Free file state tax 1. Free file state tax Enter the total amount paid in 2013 for health insurance coverage established under your business for 2013 for you, your spouse, and your dependents. Free file state tax Your insurance can also cover your child who was under age 27 at the end of 2013, even if the child was not your dependent. Free file state tax But do not include the following. Free file state tax   Amounts for any month you were eligible to participate in a health plan subsidized by your or your spouse's employer or the employer of either your dependent or your child who was under the age of 27 at the end of 2013. Free file state tax Any amounts paid from retirement plan distributions that were nontaxable because you are a retired public safety officer. Free file state tax Any amounts you included on Form 8885, line 4. Free file state tax Any qualified health insurance premiums you paid to “U. Free file state tax S. Free file state tax Treasury-HCTC. Free file state tax ” Any health coverage tax credit advance payments shown in box 1 of Form 1099-H. Free file state tax Any payments for qualified long-term care insurance (see line 2) 1. Free file state tax   2. Free file state tax For coverage under a qualified long-term care insurance contract, enter for each person covered the smaller of the following amounts. Free file state tax       a) Total payments made for that person during the year. Free file state tax       b) The amount shown below. Free file state tax Use the person's age at the end of the tax year. Free file state tax         $360— if that person is age 40 or younger          $680— if age 41 to 50         $1,360— if age 51 to 60         $3,640— if age 61 to 70         $4,550— if age 71 or older         Do not include payments for any month you were eligible to participate in a long-term care insurance plan subsidized by your or your spouse’s employer or the employer of either your dependent or your child who was under the age of 27 at the end of 2013. Free file state tax If more than one person is covered, figure separately the amount to enter for each person. Free file state tax Then enter the total of those amounts 2. Free file state tax   3. Free file state tax Add lines 1 and 2 3. Free file state tax   4. Free file state tax Enter your net profit* and any other earned income** from the trade or business under which the insurance plan is established. Free file state tax Do not include Conservation Reserve Program payments exempt from self-employment tax. Free file state tax If the business is an S corporation, skip to line 11 4. Free file state tax   5. Free file state tax Enter the total of all net profits* from: Schedule C (Form 1040), line 31; Schedule C-EZ (Form 1040), line 3; Schedule F (Form 1040), line 34; or Schedule K-1 (Form 1065), box 14, code A; plus any other income allocable to the profitable businesses. Free file state tax Do not include Conservation Reserve Program payments exempt from self-employment tax. Free file state tax See the Instructions for Schedule SE (Form 1040). Free file state tax Do not include any net losses shown on these schedules. Free file state tax 5. Free file state tax   6. Free file state tax Divide line 4 by line 5 6. Free file state tax   7. Free file state tax Multiply Form 1040, line 27, by the percentage on line 6 7. Free file state tax   8. Free file state tax Subtract line 7 from line 4 8. Free file state tax   9. Free file state tax Enter the amount, if any, from Form 1040, line 28, attributable to the same trade or business in which the insurance plan is established 9. Free file state tax   10. Free file state tax Subtract line 9 from line 8 10. Free file state tax   11. Free file state tax Enter your Medicare wages (Form W-2, box 5) from an S corporation in which you are a more-than-2% shareholder and in which the insurance plan is established 11. Free file state tax   12. Free file state tax Enter any amount from Form 2555, line 45, attributable to the amount entered on line 4 or 11 above, or any amount from Form 2555-EZ, line 18, attributable to the amount entered on line 11 above 12. Free file state tax   13. Free file state tax Subtract line 12 from line 10 or 11, whichever applies 13. Free file state tax   14. Free file state tax Enter the smaller of line 3 or line 13 here and on Form 1040, line 29. Free file state tax Do not include this amount when figuring any medical expense deduction on Schedule A (Form 1040). Free file state tax 14. Free file state tax   * If you used either optional method to figure your net earnings from self-employment from any business, do not enter your net profit from the business. Free file state tax Instead, enter the amount attributable to that business from Schedule SE (Form 1040), Section B, line 4b. Free file state tax * *Earned income includes net earnings and gains from the sale, transfer, or licensing of property you created. Free file state tax However, it does not include capital gain income. Free file state tax Chronically ill individual. Free file state tax   A chronically ill individual is a person who has been certified as one of the following. Free file state tax An individual who has been unable, due to loss of functional capacity for at least 90 days, to perform at least two activities of daily living without substantial assistance from another individual. Free file state tax Activities of daily living are eating, toileting, transferring (general mobility), bathing, dressing, and continence. Free file state tax An individual who requires substantial supervision to be protected from threats to health and safety due to severe cognitive impairment. Free file state tax The certification must have been made by a licensed health care practitioner within the previous 12 months. Free file state tax Benefits received. Free file state tax   For information on excluding benefits you receive from a long-term care contract from gross income, see Publication 525. Free file state tax Other coverage. Free file state tax   You cannot take the deduction for any month you were eligible to participate in any employer (including your spouse's) subsidized health plan at any time during that month, even if you did not actually participate. Free file state tax In addition, if you were eligible for any month or part of a month to participate in any subsidized health plan maintained by the employer of either your dependent or your child who was under age 27 at the end of 2013, do not use amounts paid for coverage for that month to figure the deduction. Free file state tax   These rules are applied separately to plans that provide long-term care insurance and plans that do not provide long-term care insurance. Free file state tax However, any medical insurance payments not deductible on Form 1040, line 29, can be included as medical expenses on Schedule A (Form 1040), Itemized Deductions, if you itemize deductions. Free file state tax Effect on itemized deductions. Free file state tax   Subtract the health insurance deduction from your medical insurance when figuring medical expenses on Schedule A (Form 1040) if you itemize deductions. Free file state tax Effect on self-employment tax. Free file state tax   For tax years beginning before or after 2010, you cannot subtract the self-employed health insurance deduction when figuring net earnings for your self-employment tax from the business under which the insurance plan is established, or considered to be established as discussed earlier. Free file state tax For more information, see Schedule SE (Form 1040). Free file state tax How to figure the deduction. Free file state tax   Generally, you can use the worksheet in the Form 1040 instructions to figure your deduction. Free file state tax However, if any of the following apply, you must use Worksheet 6-A in this chapter. Free file state tax You had more than one source of income subject to self-employment tax. Free file state tax You file Form 2555, Foreign Earned Income, or Form 2555-EZ, Foreign Earned Income Exclusion. Free file state tax You are using amounts paid for qualified long-term care insurance to figure the deduction. Free file state tax If you are claiming the health coverage tax credit, complete Form 8885, Health Coverage Tax Credit, before you figure this deduction. Free file state tax Health coverage tax credit. Free file state tax   You may be able to take this credit only if you were an eligible trade adjustment assistance (TAA) recipient, alternative TAA (ATAA) recipient, reemployment trade adjustment assistance (RTAA) recipient, or Pension Benefit Guaranty Corporation (PBGC) pension recipient. Free file state tax Use Form 8885 to figure the amount, if any, of this credit. Free file state tax   When figuring the amount to enter on line 1 of Worksheet 6-A, do not include the following. Free file state tax Any amounts you included on Form 8885, line 4. Free file state tax Any qualified health insurance premiums you paid to “U. Free file state tax S. Free file state tax Treasury-HCTC. Free file state tax ” Any health coverage tax credit advance payments shown in box 1 of Form 1099-H, Health Coverage Tax Credit (HCTC) Advance Payments. Free file state tax More than one health plan and business. Free file state tax   If you have more than one health plan during the year and each plan is established under a different business, you must use separate worksheets (Worksheet 6-A) to figure each plan's net earnings limit. Free file state tax Include the premium you paid under each plan on line 1 or line 2 of that separate worksheet and your net profit (or wages) from that business on line 4 (or line 11). Free file state tax For a plan that provides long-term care insurance, the total of the amounts entered for each person on line 2 of all worksheets cannot be more than the appropriate limit shown on line 2 for that person. Free file state tax Nondeductible Premiums You cannot deduct premiums on the following kinds of insurance. Free file state tax Self-insurance reserve funds. Free file state tax You cannot deduct amounts credited to a reserve set up for self-insurance. Free file state tax This applies even if you cannot get business insurance coverage for certain business risks. Free file state tax However, your actual losses may be deductible. Free file state tax See Publication 547. Free file state tax Loss of earnings. Free file state tax You cannot deduct premiums for a policy that pays for lost earnings due to sickness or disability. Free file state tax However, see the discussion on overhead insurance, item (8), under Deductible Premiums , earlier. Free file state tax Certain life insurance and annuities. Free file state tax For contracts issued before June 9, 1997, you cannot deduct the premiums on a life insurance policy covering you, an employee, or any person with a financial interest in your business if you are directly or indirectly a beneficiary of the policy. Free file state tax You are included among possible beneficiaries of the policy if the policy owner is obligated to repay a loan from you using the proceeds of the policy. Free file state tax A person has a financial interest in your business if the person is an owner or part owner of the business or has lent money to the business. Free file state tax For contracts issued after June 8, 1997, you generally cannot deduct the premiums on any life insurance policy, endowment contract, or annuity contract if you are directly or indirectly a beneficiary. Free file state tax The disallowance applies without regard to whom the policy covers. Free file state tax Partners. Free file state tax If, as a partner in a partnership, you take out an insurance policy on your own life and name your partners as beneficiaries to induce them to retain their investments in the partnership, you are considered a beneficiary. Free file state tax You cannot deduct the insurance premiums. Free file state tax Insurance to secure a loan. Free file state tax If you take out a policy on your life or on the life of another person with a financial interest in your business to get or protect a business loan, you cannot deduct the premiums as a business expense. Free file state tax Nor can you deduct the premiums as interest on business loans or as an expense of financing loans. Free file state tax In the event of death, the proceeds of the policy are generally not taxed as income even if they are used to liquidate the debt. Free file state tax Capitalized Premiums Under the uniform capitalization rules, you must capitalize the direct costs and part of the indirect costs for certain production or resale activities. Free file state tax Include these costs in the basis of property you produce or acquire for resale, rather than claiming them as a current deduction. Free file state tax You recover the costs through depreciation, amortization, or cost of goods sold when you use, sell, or otherwise dispose of the property. Free file state tax Indirect costs include premiums for insurance on your plant or facility, machinery, equipment, materials, property produced, or property acquired for resale. Free file state tax Uniform capitalization rules. Free file state tax   You may be subject to the uniform capitalization rules if you do any of the following, unless the property is produced for your use other than in a business or an activity carried on for profit. Free file state tax Produce real property or tangible personal property. Free file state tax For this purpose, tangible personal property includes a film, sound recording, video tape, book, or similar property. Free file state tax Acquire property for resale. Free file state tax However, these rules do not apply to the following property. Free file state tax Personal property you acquire for resale if your average annual gross receipts are $10 million or less for the 3 prior tax years. Free file state tax Property you produce if you meet either of the following conditions. Free file state tax Your indirect costs of producing the property are $200,000 or less. Free file state tax You use the cash method of accounting and do not account for inventories. Free file state tax More information. Free file state tax   For more information on these rules, see Uniform Capitalization Rules in Publication 538 and the regulations under Internal Revenue Code section 263A. Free file state tax When To Deduct Premiums You can usually deduct insurance premiums in the tax year to which they apply. Free file state tax Cash method. Free file state tax   If you use the cash method of accounting, you generally deduct insurance premiums in the tax year you actually paid them, even if you incurred them in an earlier year. Free file state tax However, see Prepayment , later. Free file state tax Accrual method. Free file state tax   If you use an accrual method of accounting, you cannot deduct insurance premiums before the tax year in which you incur a liability for them. Free file state tax In addition, you cannot deduct insurance premiums before the tax year in which you actually pay them (unless the exception for recurring items applies). Free file state tax For more information about the accrual method of accounting, see chapter 1. Free file state tax For information about the exception for recurring items, see Publication 538. Free file state tax Prepayment. Free file state tax   You cannot deduct expenses in advance, even if you pay them in advance. Free file state tax This rule applies to any expense paid far enough in advance to, in effect, create an asset with a useful life extending substantially beyond the end of the current tax year. Free file state tax   Expenses such as insurance are generally allocable to a period of time. Free file state tax You can deduct insurance expenses for the year to which they are allocable. Free file state tax Example. Free file state tax In 2013, you signed a 3-year insurance contract. Free file state tax Even though you paid the premiums for 2013, 2014, and 2015 when you signed the contract, you can only deduct the premium for 2013 on your 2013 tax return. Free file state tax You can deduct in 2014 and 2015 the premium allocable to those years. Free file state tax Dividends received. Free file state tax   If you receive dividends from business insurance and you deducted the premiums in prior years, at least part of the dividends generally are income. Free file state tax For more information, see Recovery of amount deducted (tax benefit rule) in chapter 1 under How Much Can I Deduct. Free file state tax Prev  Up  Next   Home   More Online Publications
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The Free File State Tax

Free file state tax 18. Free file state tax   Appendix This appendix contains models of the certificates, waivers, reports, and statements discussed in Part One. Free file state tax Model Certificate A   STATEMENT OF SUBSEQUENT SELLER     1. Free file state tax                 Name, address, and employer identification number of seller in subsequent sale             2. Free file state tax                 Name, address, and employer identification number of the buyer in subsequent sale             3. Free file state tax         Date and location of subsequent sale             4. Free file 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. Free file 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. Free file state tax                   Signature and date signed                   Printed or typed name of person signing this report                   Title—   Model Certificate B   FIRST TAXPAYER'S REPORT   1. Free file state tax                     First Taxpayer's name, address and employer identification number     2. Free file state tax                     Name, address, and employer identification number of the buyer of the taxable fuel subject to tax     3. Free file state tax           Date and location of removal, entry, or sale       4. Free file state tax           Volume and type of taxable fuel removed, entered or sold     5. Free file 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. Free file 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. Free file 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. Free file 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. Free file 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. Free file 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. Free file 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. Free file state tax       This certificate applies to the following (complete as applicable):       If this is a single purchase certificate, check here and enter:     1. Free file state tax Invoice or delivery ticket number       2. Free file 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. Free file state tax Effective date       2. Free file state tax Expiration date       (period not to exceed 1 year after the effective date)       3. Free file state tax Type (or types) of gasoline blendstocks     4. Free file 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. Free file state tax         Buyer will provide a new certificate to the seller if any information in this certificate changes. Free file 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. Free file state tax 4081-4(b)(3) of the Manufacturers and Retailers Excise Tax Regulations. Free file 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. Free file state tax       Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. Free file 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. Free file 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. Free file 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. Free file state tax )         (Buyer) certifies the following under penalties of perjury:       Name of buyer         Buyer is a registered feedstock user with registration number . Free file state tax Buyer's registration has not been revoked     or suspended. Free file state tax         The kerosene to which this certificate applies will be used by Buyer for a feedstock purpose. Free file 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. Free file state tax A single purchase on invoice or delivery ticket number . Free file state tax                 2. Free file 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) . Free file state tax If this certificate applies only to Buyer's     purchases for certain locations, check here and list the locations. Free file state tax                                   If Buyer sells the kerosene to which this certificate relates, Buyer will be liable for tax on that sale. Free file state tax                 Buyer will provide a new certificate to the seller if any information in this certificate changes. Free file state tax                 If Buyer violates the terms of this certificate, the Internal Revenue Service may revoke the Buyer's registration. Free file 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. Free file 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. Free file 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. Free file state tax       This certificate applies to the following (complete as applicable):               If this is a single purchase certificate, check here and enter:       1. Free file state tax Invoice or delivery ticket number       2. Free file 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. Free file state tax Effective date         2. Free file state tax Expiration date         (period not to exceed 1 year after the effective date)         3. Free file 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. Free file state tax       Buyer will provide a new certificate to the seller if any information in this certificate changes. Free file 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. Free file state tax       Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. Free file 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. Free file 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. Free file 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. Free file 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). Free file 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. Free file state tax Buyer's registration has not been suspended or revoked by the Internal Revenue Service. Free file state tax       This certificate applies to the following (complete as applicable):     This is a single purchase certificate:       1. Free file state tax Invoice or delivery ticket number       2. Free file state tax Number of gallons     This is a certificate covering all purchases under a specified account or order number:       1. Free file state tax Effective date       2. Free file state tax Expiration date (period not to exceed 1 year after the effective date)       3. Free file 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. Free file 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. Free file 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. Free file 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. Free file state tax     Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. Free file state tax     If Buyer violates the terms of this certificate, the Internal Revenue Service may withdraw Buyer's right to provide a certificate. Free file 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. Free file 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. Free file 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. Free file state tax The kerosene to which this waiver relates is purchased for — (check one):       1. Free file state tax □ Use on a farm for farming purposes,       2. Free file state tax □ Use in foreign trade (reciprocal benefits required for foreign registered airlines),       3. Free file state tax □ Use in certain helicopter and fixed-wing air ambulance uses,       4. Free file state tax □ The exclusive use of a qualified blood collector organization,       5. Free file state tax □ The exclusive use of a nonprofit educational organization,       6. Free file state tax □ Use in an aircraft owned by an aircraft museum,       7. Free file state tax □ Use in military aircraft, or       8. Free file state tax □ Use in commercial aviation (other than foreign trade). Free file state tax     B. Free file state tax This waiver applies to the following (complete as applicable):       This is a single purchase waiver:           1. Free file state tax Invoice or delivery ticket number           2. Free file state tax Number of gallons       This is a waiver covering all purchases under a specified account or order number:           1. Free file state tax Effective date           2. Free file state tax Expiration date (period not to exceed 1 year after the effective date)           3. Free file state tax Buyer's account number       Buyer will provide a new waiver to the vendor if any information in this waiver changes. Free file 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. Free file 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. Free file 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. Free file 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. Free file 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. Free file 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. Free file state tax       This certificate applies to the following (complete as applicable):     This is a single purchase certificate:       1. Free file state tax Invoice or delivery ticket number       2. Free file state tax Number of gallons     This is a certificate covering all purchases under a specified account or order number:       1. Free file state tax Effective date       2. Free file state tax Expiration date (period not to exceed 1 year after the effective date)       3. Free file state tax Buyer's account number       Buyer will provide a new certificate to the vendor if any information in this certificate changes. Free file 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. Free file 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. Free file 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. Free file 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. Free file 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. Free file state tax       This waiver applies to the following (complete as applicable):     This is a single purchase waiver:       1. Free file state tax Invoice or delivery ticket number       2. Free file state tax Number of gallons     This is a waiver covering all purchases under a specified account or order number:       1. Free file state tax Effective date       2. Free file state tax Expiration date (period not to exceed 1 year after the effective date)       3. Free file state tax Buyer's account number       Buyer will provide a new waiver to the vendor if any information in this waiver changes. Free file 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. Free file 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. Free file 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. Free file 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. Free file 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. Free file state tax )     The undersigned biodiesel producer (“Producer”) hereby certifies the following under penalties of perjury:   1. Free file state tax             Producer's name, address, and employer identification number (EIN)   2. Free file state tax             Name, address, and EIN of person buying the biodiesel from Producer   3. Free file state tax       Date and location of sale to buyer   4. Free file state tax This certificate applies to gallons of biodiesel. Free file state tax   5. Free file 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. Free file 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. Free file state tax Original Certificate Identification Number (only in the case of certificates reissued to a reseller after return of the original certificate). Free file state tax       Producer is registered as a biodiesel producer with registration number . Free file state tax  Producer's registration has not been suspended or revoked by the Internal Revenue Service. Free file 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. Free file state tax S. Free file state tax C. Free file state tax 7545). Free file 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. Free file 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. Free file state tax )               Name, Address, and Employer Identification Number of Vendor     The undersigned buyer (“Buyer”) hereby certifies the following under penalties of perjury:     A. Free file 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. Free file state tax     B. Free file state tax This certificate applies to the following (complete as applicable):       1. Free file state tax   If this is a single purchase certificate, check here □ and enter:           a. Free file state tax Invoice or delivery ticket number           b. Free file state tax Number of gallons       2. Free file state tax   If this is a certificate covering all purchases under a specified account or order number, check here □  and enter:           a. Free file state tax Effective date           b. Free file state tax Expiration date   (period not to exceed 1 year after effective date)           c. Free file state tax Buyer's account or order number     ▪ Buyer will provide a new certificate to the vendor if any information in this certificate changes. Free file 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. Free file 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. Free file 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. Free file 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. Free file 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. Free file state tax The kerosene to which this certificate relates is purchased for a nonexempt use in noncommercial aviation. Free file state tax     B. Free file state tax This certificate applies to the following (complete as applicable):       1. Free file state tax   If this is a single purchase certificate, check here □ and enter:           a. Free file state tax Invoice or delivery ticket number           b. Free file state tax Number of gallons       2. Free file state tax   This is a certificate covering all purchases under a specified account or order number:           a. Free file state tax Effective date           b. Free file state tax Expiration date   (period not to exceed 1 year after effective date)           c. Free file state tax Buyer's account number     ▪ Buyer will provide a new certificate to the vendor if any information in this certificate changes. Free file 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. Free file 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. Free file 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. Free file state tax )               Name, Address, and Employer Identification Number of Credit Card Issuer. Free file state tax     The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under penalties of perjury:     A. Free file state tax Buyer will use the taxable fuel to which this certificate relates for the exclusive use of a state; or     B. Free file state tax Buyer will use the gasoline to which this certificate relates for the exclusive use of a nonprofit educational organization. Free file state tax     C. Free file state tax This certificate applies to all purchases made with the credit card identified below during the period specified:           a. Free file state tax Effective date of certificate           b. Free file state tax Expiration date of certificate   (period not to exceed 2 years after effective date)           c. Free file state tax Buyer's account number     ▪ Buyer will provide a new certificate to the credit card issuer if any information in this certificate changes. Free file 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. Free file 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. Free file 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. Free file 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. Free file state tax )     The undersigned biodiesel producer (“Reseller”) hereby certifies the following under penalties of perjury:   1. Free file state tax                   Reseller's name, address, and employer identification number (EIN)   2. Free file state tax                   Name, address, and EIN of Reseller's buyer   3. Free file state tax       Date and location of sale to buyer   4. Free file state tax Volume of biodiesel sold   5. Free file 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. Free file state tax       Reseller has not been notified by the Internal Revenue Service that its right to provide a certificate or statement has been withdrawn. Free file 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. Free file 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