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2010 Form 1040nr

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2010 Form 1040nr

2010 form 1040nr IRAs and Other Retirement Plans Table of Contents 2002 ChangesSimplified Employee Pensions (SEPs) 403(b) Plans Later ChangeDeemed IRAs 2002 Changes Simplified Employee Pensions (SEPs) Contribution limit increased. 2010 form 1040nr   For plan years beginning after December 31, 2001, the annual limit on the amount of employer contributions to a SEP increases to the lesser of the following amounts. 2010 form 1040nr 25% of an eligible employee's compensation. 2010 form 1040nr $40,000 (subject to cost-of-living adjustments after 2002). 2010 form 1040nr Deduction limit. 2010 form 1040nr   For years beginning after 2001, the following changes apply to the SEP deduction limit. 2010 form 1040nr Elective deferrals (SARSEPs). 2010 form 1040nr   Elective deferrals under a SARSEP are not subject to the deduction limit that applies to employer contributions. 2010 form 1040nr Also, elective deferrals are not taken into account when figuring the amount you can deduct for employer contributions that are not elective deferrals. 2010 form 1040nr Definition of compensation. 2010 form 1040nr    Compensation for figuring the deduction for employer contributions includes elective deferrals under a SARSEP. 2010 form 1040nr More information. 2010 form 1040nr   For more information about SEPs, see Publication 560, Retirement Plans for Small Business. 2010 form 1040nr 403(b) Plans Figuring catch-up contributions. 2010 form 1040nr   When figuring allowable catch-up contributions, combine all contributions made by your employer on your behalf to the following plans. 2010 form 1040nr Qualified retirement plans. 2010 form 1040nr 403(b) plans. 2010 form 1040nr Simplified employee pensions (SEP). 2010 form 1040nr SIMPLE plans. 2010 form 1040nr   The total amount of the catch-up contributions to all plans maintained by your employer cannot exceed the annual limit. 2010 form 1040nr For 2002, the limit is $1,000. 2010 form 1040nr Rollovers to and from 403(b) plans. 2010 form 1040nr   If a distribution includes both pre-tax contributions and after-tax contributions, the portion of the distribution that is rolled over is treated as consisting first of pre-tax amounts (contributions and earnings that would be includible in income if no rollover occurred). 2010 form 1040nr This means that if you roll over an amount that is at least as much as the pre-tax portion of the distribution, you do not have to include any of the distribution in income. 2010 form 1040nr Years of service for church employees and ministers. 2010 form 1040nr   If you are a minister or church employee, treat all of your years of service as an employee of a church or a convention or association of churches as years of service with one employer. 2010 form 1040nr Prior law required church employees and ministers to figure years of service separately for each employer. 2010 form 1040nr   As a minister or church employee, all contributions made to 403(b) plans on your behalf, as an employee of a church or a convention or association of churches, are considered made by one employer. 2010 form 1040nr Foreign missionaries. 2010 form 1040nr   If you are a foreign missionary, contributions to your 403(b) account will not be treated as exceeding the limit on annual additions if the contributions are not more than the greater of: $3,000, or Your includible compensation. 2010 form 1040nr More information. 2010 form 1040nr   For more information about 403(b) plans, see Publication 571, Tax-Sheltered Annuity Plans (403(b) Plans). 2010 form 1040nr Later Change Deemed IRAs For plan years beginning after 2002, a qualified employer plan can provide for voluntary employee contributions to a separate account or annuity that is deemed to be an IRA. 2010 form 1040nr For this purpose, a qualified employer plan includes a deferred compensation plan (section 457(b) plan) maintained by a state, a political subdivision of a state, or an agency or instrumentality of a state or political subdivision of a state. 2010 form 1040nr The term qualified employer plan also includes: A qualified pension, profit-sharing, or stock bonus plan (section 401(a) plan), A qualified employee annuity plan (section 403(a) plan), and A tax-sheltered annuity plan (section 403(b) plan). 2010 form 1040nr More information about IRAs can be found in Publication 590, Individual Retirement Arrangements (IRAs). 2010 form 1040nr Prev  Up  Next   Home   More Online Publications
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Can I Deduct My Mortgage Related Expenses?

This application will determine if you are able to deduct amounts you paid for Mortgage interest, Points, Mortgage Insurance Premiums and other Mortgage Related Expenses.

Information You Will Need:

  • Your and your spouse's filing status
  • Basic income information including amounts of your income
  • An estimated total (if applicable) of the amounts paid for mortgage interest, points and/or mortgage insurance premiums (normally reported to you on Form 1099-G)

Estimated Completion Time: 12 minutes. However: 5 minutes of inactivity will end the interview and you will be forced to start over.

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Page Last Reviewed or Updated: 14-Feb-2014

The 2010 Form 1040nr

2010 form 1040nr 18. 2010 form 1040nr   Appendix This appendix contains models of the certificates, waivers, reports, and statements discussed in Part One. 2010 form 1040nr Model Certificate A   STATEMENT OF SUBSEQUENT SELLER     1. 2010 form 1040nr                 Name, address, and employer identification number of seller in subsequent sale             2. 2010 form 1040nr                 Name, address, and employer identification number of the buyer in subsequent sale             3. 2010 form 1040nr         Date and location of subsequent sale             4. 2010 form 1040nr         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. 2010 form 1040nr       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. 2010 form 1040nr                   Signature and date signed                   Printed or typed name of person signing this report                   Title—   Model Certificate B   FIRST TAXPAYER'S REPORT   1. 2010 form 1040nr                     First Taxpayer's name, address and employer identification number     2. 2010 form 1040nr                     Name, address, and employer identification number of the buyer of the taxable fuel subject to tax     3. 2010 form 1040nr           Date and location of removal, entry, or sale       4. 2010 form 1040nr           Volume and type of taxable fuel removed, entered or sold     5. 2010 form 1040nr 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. 2010 form 1040nr           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. 2010 form 1040nr       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. 2010 form 1040nr             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. 2010 form 1040nr                 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. 2010 form 1040nr                       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. 2010 form 1040nr )                 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. 2010 form 1040nr       This certificate applies to the following (complete as applicable):       If this is a single purchase certificate, check here and enter:     1. 2010 form 1040nr Invoice or delivery ticket number       2. 2010 form 1040nr (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. 2010 form 1040nr Effective date       2. 2010 form 1040nr Expiration date       (period not to exceed 1 year after the effective date)       3. 2010 form 1040nr Type (or types) of gasoline blendstocks     4. 2010 form 1040nr 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. 2010 form 1040nr         Buyer will provide a new certificate to the seller if any information in this certificate changes. 2010 form 1040nr       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. 2010 form 1040nr 4081-4(b)(3) of the Manufacturers and Retailers Excise Tax Regulations. 2010 form 1040nr       Buyer understands that if Buyer violates the terms of this certificate, the Internal Revenue Service may withdraw Buyer's     right to provide a certificate. 2010 form 1040nr       Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. 2010 form 1040nr     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. 2010 form 1040nr       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. 2010 form 1040nr             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. 2010 form 1040nr )         (Buyer) certifies the following under penalties of perjury:       Name of buyer         Buyer is a registered feedstock user with registration number . 2010 form 1040nr Buyer's registration has not been revoked     or suspended. 2010 form 1040nr         The kerosene to which this certificate applies will be used by Buyer for a feedstock purpose. 2010 form 1040nr                 This certificate applies to percent of Buyer's purchases from (name, address, and employer     identification number of seller) as follows (complete as applicable):       1. 2010 form 1040nr A single purchase on invoice or delivery ticket number . 2010 form 1040nr                 2. 2010 form 1040nr All purchases between (effective date) and (expiration date) (period not to exceed     one year after the effective date) under account or order number(s) . 2010 form 1040nr If this certificate applies only to Buyer's     purchases for certain locations, check here and list the locations. 2010 form 1040nr                                   If Buyer sells the kerosene to which this certificate relates, Buyer will be liable for tax on that sale. 2010 form 1040nr                 Buyer will provide a new certificate to the seller if any information in this certificate changes. 2010 form 1040nr                 If Buyer violates the terms of this certificate, the Internal Revenue Service may revoke the Buyer's registration. 2010 form 1040nr                 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. 2010 form 1040nr             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. 2010 form 1040nr )                                         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. 2010 form 1040nr       This certificate applies to the following (complete as applicable):               If this is a single purchase certificate, check here and enter:       1. 2010 form 1040nr Invoice or delivery ticket number       2. 2010 form 1040nr (Gasoline gallon equivalents)       If this is a certificate covering all purchases under a specified account or order number, check here and enter:         1. 2010 form 1040nr Effective date         2. 2010 form 1040nr Expiration date         (period not to exceed 1 year after the effective date)         3. 2010 form 1040nr 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. 2010 form 1040nr       Buyer will provide a new certificate to the seller if any information in this certificate changes. 2010 form 1040nr       Buyer understands that if Buyer violates the terms of this certificate, the Internal Revenue Service may withdraw Buyer's     right to provide a certificate. 2010 form 1040nr       Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. 2010 form 1040nr     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. 2010 form 1040nr       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. 2010 form 1040nr             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. 2010 form 1040nr )           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). 2010 form 1040nr       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. 2010 form 1040nr Buyer's registration has not been suspended or revoked by the Internal Revenue Service. 2010 form 1040nr       This certificate applies to the following (complete as applicable):     This is a single purchase certificate:       1. 2010 form 1040nr Invoice or delivery ticket number       2. 2010 form 1040nr Number of gallons     This is a certificate covering all purchases under a specified account or order number:       1. 2010 form 1040nr Effective date       2. 2010 form 1040nr Expiration date (period not to exceed 1 year after the effective date)       3. 2010 form 1040nr Buyer's account number       Buyer agrees to provide the person liable for tax with a new certificate if any information in this certificate changes. 2010 form 1040nr       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. 2010 form 1040nr       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. 2010 form 1040nr       Buyer understands that it must be prepared to establish by satisfactory evidence the purpose for which the     fuel purchased under this certificate was used. 2010 form 1040nr     Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. 2010 form 1040nr     If Buyer violates the terms of this certificate, the Internal Revenue Service may withdraw Buyer's right to provide a certificate. 2010 form 1040nr       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. 2010 form 1040nr           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. 2010 form 1040nr )               Name, Address, and Employer Identification Number of Ultimate Vendor     The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under penalties of perjury:     A. 2010 form 1040nr The kerosene to which this waiver relates is purchased for — (check one):       1. 2010 form 1040nr □ Use on a farm for farming purposes,       2. 2010 form 1040nr □ Use in foreign trade (reciprocal benefits required for foreign registered airlines),       3. 2010 form 1040nr □ Use in certain helicopter and fixed-wing air ambulance uses,       4. 2010 form 1040nr □ The exclusive use of a qualified blood collector organization,       5. 2010 form 1040nr □ The exclusive use of a nonprofit educational organization,       6. 2010 form 1040nr □ Use in an aircraft owned by an aircraft museum,       7. 2010 form 1040nr □ Use in military aircraft, or       8. 2010 form 1040nr □ Use in commercial aviation (other than foreign trade). 2010 form 1040nr     B. 2010 form 1040nr This waiver applies to the following (complete as applicable):       This is a single purchase waiver:           1. 2010 form 1040nr Invoice or delivery ticket number           2. 2010 form 1040nr Number of gallons       This is a waiver covering all purchases under a specified account or order number:           1. 2010 form 1040nr Effective date           2. 2010 form 1040nr Expiration date (period not to exceed 1 year after the effective date)           3. 2010 form 1040nr Buyer's account number       Buyer will provide a new waiver to the vendor if any information in this waiver changes. 2010 form 1040nr       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. 2010 form 1040nr       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. 2010 form 1040nr       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. 2010 form 1040nr       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. 2010 form 1040nr           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. 2010 form 1040nr )                       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. 2010 form 1040nr       This certificate applies to the following (complete as applicable):     This is a single purchase certificate:       1. 2010 form 1040nr Invoice or delivery ticket number       2. 2010 form 1040nr Number of gallons     This is a certificate covering all purchases under a specified account or order number:       1. 2010 form 1040nr Effective date       2. 2010 form 1040nr Expiration date (period not to exceed 1 year after the effective date)       3. 2010 form 1040nr Buyer's account number       Buyer will provide a new certificate to the vendor if any information in this certificate changes. 2010 form 1040nr       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. 2010 form 1040nr       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. 2010 form 1040nr       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. 2010 form 1040nr           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. 2010 form 1040nr )                       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. 2010 form 1040nr       This waiver applies to the following (complete as applicable):     This is a single purchase waiver:       1. 2010 form 1040nr Invoice or delivery ticket number       2. 2010 form 1040nr Number of gallons     This is a waiver covering all purchases under a specified account or order number:       1. 2010 form 1040nr Effective date       2. 2010 form 1040nr Expiration date (period not to exceed 1 year after the effective date)       3. 2010 form 1040nr Buyer's account number       Buyer will provide a new waiver to the vendor if any information in this waiver changes. 2010 form 1040nr       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. 2010 form 1040nr       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. 2010 form 1040nr       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. 2010 form 1040nr       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. 2010 form 1040nr           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. 2010 form 1040nr )     The undersigned biodiesel producer (“Producer”) hereby certifies the following under penalties of perjury:   1. 2010 form 1040nr             Producer's name, address, and employer identification number (EIN)   2. 2010 form 1040nr             Name, address, and EIN of person buying the biodiesel from Producer   3. 2010 form 1040nr       Date and location of sale to buyer   4. 2010 form 1040nr This certificate applies to gallons of biodiesel. 2010 form 1040nr   5. 2010 form 1040nr 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. 2010 form 1040nr             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. 2010 form 1040nr Original Certificate Identification Number (only in the case of certificates reissued to a reseller after return of the original certificate). 2010 form 1040nr       Producer is registered as a biodiesel producer with registration number . 2010 form 1040nr  Producer's registration has not been suspended or revoked by the Internal Revenue Service. 2010 form 1040nr       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. 2010 form 1040nr S. 2010 form 1040nr C. 2010 form 1040nr 7545). 2010 form 1040nr       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. 2010 form 1040nr           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. 2010 form 1040nr )               Name, Address, and Employer Identification Number of Vendor     The undersigned buyer (“Buyer”) hereby certifies the following under penalties of perjury:     A. 2010 form 1040nr 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. 2010 form 1040nr     B. 2010 form 1040nr This certificate applies to the following (complete as applicable):       1. 2010 form 1040nr   If this is a single purchase certificate, check here □ and enter:           a. 2010 form 1040nr Invoice or delivery ticket number           b. 2010 form 1040nr Number of gallons       2. 2010 form 1040nr   If this is a certificate covering all purchases under a specified account or order number, check here □  and enter:           a. 2010 form 1040nr Effective date           b. 2010 form 1040nr Expiration date   (period not to exceed 1 year after effective date)           c. 2010 form 1040nr Buyer's account or order number     ▪ Buyer will provide a new certificate to the vendor if any information in this certificate changes. 2010 form 1040nr     ▪ 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. 2010 form 1040nr     ▪ 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. 2010 form 1040nr     ▪ 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. 2010 form 1040nr           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. 2010 form 1040nr )               Name, Address, and Employer Identification Number of Ultimate Vendor     The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under penalties of perjury:     A. 2010 form 1040nr The kerosene to which this certificate relates is purchased for a nonexempt use in noncommercial aviation. 2010 form 1040nr     B. 2010 form 1040nr This certificate applies to the following (complete as applicable):       1. 2010 form 1040nr   If this is a single purchase certificate, check here □ and enter:           a. 2010 form 1040nr Invoice or delivery ticket number           b. 2010 form 1040nr Number of gallons       2. 2010 form 1040nr   This is a certificate covering all purchases under a specified account or order number:           a. 2010 form 1040nr Effective date           b. 2010 form 1040nr Expiration date   (period not to exceed 1 year after effective date)           c. 2010 form 1040nr Buyer's account number     ▪ Buyer will provide a new certificate to the vendor if any information in this certificate changes. 2010 form 1040nr     ▪ 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. 2010 form 1040nr     ▪ 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. 2010 form 1040nr           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. 2010 form 1040nr )               Name, Address, and Employer Identification Number of Credit Card Issuer. 2010 form 1040nr     The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under penalties of perjury:     A. 2010 form 1040nr Buyer will use the taxable fuel to which this certificate relates for the exclusive use of a state; or     B. 2010 form 1040nr Buyer will use the gasoline to which this certificate relates for the exclusive use of a nonprofit educational organization. 2010 form 1040nr     C. 2010 form 1040nr This certificate applies to all purchases made with the credit card identified below during the period specified:           a. 2010 form 1040nr Effective date of certificate           b. 2010 form 1040nr Expiration date of certificate   (period not to exceed 2 years after effective date)           c. 2010 form 1040nr Buyer's account number     ▪ Buyer will provide a new certificate to the credit card issuer if any information in this certificate changes. 2010 form 1040nr     ▪ 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. 2010 form 1040nr     ▪ 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. 2010 form 1040nr     ▪ 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. 2010 form 1040nr           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. 2010 form 1040nr )     The undersigned biodiesel producer (“Reseller”) hereby certifies the following under penalties of perjury:   1. 2010 form 1040nr                   Reseller's name, address, and employer identification number (EIN)   2. 2010 form 1040nr                   Name, address, and EIN of Reseller's buyer   3. 2010 form 1040nr       Date and location of sale to buyer   4. 2010 form 1040nr Volume of biodiesel sold   5. 2010 form 1040nr 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. 2010 form 1040nr       Reseller has not been notified by the Internal Revenue Service that its right to provide a certificate or statement has been withdrawn. 2010 form 1040nr       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. 2010 form 1040nr           Printed or typed name of person signing this certificate           Title of person signing           Signature and date signed   Prev  Up  Next   Home   More Online Publications