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Irs E File 2013

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Irs E File 2013

Irs e file 2013 Publication 575 - Additional Material Table of Contents Worksheet A. Irs e file 2013 Simplified Method 1. Irs e file 2013 Enter the total pension or annuity payments received this year. Irs e file 2013 Also, add this amount to the total for Form 1040, line 16a; Form 1040A, line 12a; or Form 1040NR, line 17a 1. Irs e file 2013   2. Irs e file 2013 Enter your cost in the plan (contract) at the annuity starting date plus any death benefit exclusion. Irs e file 2013 * See Cost (Investment in the Contract) , earlier 2. Irs e file 2013   Note: If your annuity starting date was before this year and you completed this worksheet last year, skip line 3 and enter the amount from line 4 of last year's worksheet on line 4 below (even if the amount of your pension or annuity has changed). Irs e file 2013 Otherwise, go to line 3. Irs e file 2013   3. Irs e file 2013 Enter the appropriate number from Table 1 below. Irs e file 2013 But if your annuity starting date was after 1997 and the payments are for your life and that of your beneficiary, enter the appropriate number from Table 2 below. Irs e file 2013 3. Irs e file 2013   4. Irs e file 2013 Divide line 2 by the number on line 3 4. Irs e file 2013   5. Irs e file 2013 Multiply line 4 by the number of months for which this year's payments were made. Irs e file 2013 If your annuity starting date was before 1987, enter this amount on line 8 below and skip lines 6, 7, 10, and 11. Irs e file 2013 Otherwise, go to line 6 5. Irs e file 2013   6. Irs e file 2013 Enter any amounts previously recovered tax free in years after 1986. Irs e file 2013 This is the amount shown on line 10 of your worksheet for last year 6. Irs e file 2013   7. Irs e file 2013 Subtract line 6 from line 2 7. Irs e file 2013   8. Irs e file 2013 Enter the smaller of line 5 or line 7 8. Irs e file 2013   9. Irs e file 2013 Taxable amount for year. Irs e file 2013 Subtract line 8 from line 1. Irs e file 2013 Enter the result, but not less than zero. Irs e file 2013 Also, add this amount to the total for Form 1040, line 16b; Form 1040A, line 12b; or Form 1040NR, line 17b. Irs e file 2013  Note: If your Form 1099-R shows a larger taxable amount, use the amount figured on this line instead. Irs e file 2013 If you are a retired public safety officer, see Insurance Premiums for Retired Public Safety Officers , earlier, before entering an amount on your tax return 9. Irs e file 2013   10. Irs e file 2013 Was your annuity starting date before 1987? □ Yes. Irs e file 2013 STOP. Irs e file 2013 Do not complete the rest of this worksheet. Irs e file 2013  □ No. Irs e file 2013 Add lines 6 and 8. Irs e file 2013 This is the amount you have recovered tax free through 2013. Irs e file 2013 You will need this number if you need to fill out this worksheet next year 10. Irs e file 2013   11. Irs e file 2013 Balance of cost to be recovered. Irs e file 2013 Subtract line 10 from line 2. Irs e file 2013 If zero, you will not have to complete this worksheet next year. Irs e file 2013 The payments you receive next year will generally be fully taxable 11. Irs e file 2013   * A death benefit exclusion (up to $5,000) applied to certain benefits received by employees who died before August 21, 1996. Irs e file 2013 Table 1 for Line 3 Above   IF the age at  annuity starting date was . Irs e file 2013 . Irs e file 2013 . Irs e file 2013         AND your annuity starting date was—     BEFORE November 19, 1996,  enter on line 3 . Irs e file 2013 . Irs e file 2013 . Irs e file 2013 AFTER November 18, 1996,  enter on line 3 . Irs e file 2013 . Irs e file 2013 . Irs e file 2013   55 or under 300 360   56-60 260 310   61-65 240 260   66-70 170 210   71 or over 120 160 Table 2 for Line 3 Above   IF the combined ages at annuity starting date were . Irs e file 2013 . Irs e file 2013 . Irs e file 2013   THEN enter on line 3 . Irs e file 2013 . Irs e file 2013 . Irs e file 2013         110 or under   410         111-120   360         121-130   310         131-140   260         141 or over   210       Prev  Up  Next   Home   More Online Publications
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Page Last Reviewed or Updated: 15-Nov-2013

The Irs E File 2013

Irs e file 2013 18. Irs e file 2013   Appendix This appendix contains models of the certificates, waivers, reports, and statements discussed in Part One. Irs e file 2013 Model Certificate A   STATEMENT OF SUBSEQUENT SELLER     1. Irs e file 2013                 Name, address, and employer identification number of seller in subsequent sale             2. Irs e file 2013                 Name, address, and employer identification number of the buyer in subsequent sale             3. Irs e file 2013         Date and location of subsequent sale             4. Irs e file 2013         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. Irs e file 2013       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. Irs e file 2013                   Signature and date signed                   Printed or typed name of person signing this report                   Title—   Model Certificate B   FIRST TAXPAYER'S REPORT   1. Irs e file 2013                     First Taxpayer's name, address and employer identification number     2. Irs e file 2013                     Name, address, and employer identification number of the buyer of the taxable fuel subject to tax     3. Irs e file 2013           Date and location of removal, entry, or sale       4. Irs e file 2013           Volume and type of taxable fuel removed, entered or sold     5. Irs e file 2013 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. Irs e file 2013           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. Irs e file 2013       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. Irs e file 2013             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. Irs e file 2013                 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. Irs e file 2013                       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. Irs e file 2013 )                 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. Irs e file 2013       This certificate applies to the following (complete as applicable):       If this is a single purchase certificate, check here and enter:     1. Irs e file 2013 Invoice or delivery ticket number       2. Irs e file 2013 (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. Irs e file 2013 Effective date       2. Irs e file 2013 Expiration date       (period not to exceed 1 year after the effective date)       3. Irs e file 2013 Type (or types) of gasoline blendstocks     4. Irs e file 2013 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. Irs e file 2013         Buyer will provide a new certificate to the seller if any information in this certificate changes. Irs e file 2013       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. Irs e file 2013 4081-4(b)(3) of the Manufacturers and Retailers Excise Tax Regulations. Irs e file 2013       Buyer understands that if Buyer violates the terms of this certificate, the Internal Revenue Service may withdraw Buyer's     right to provide a certificate. Irs e file 2013       Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. Irs e file 2013     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. Irs e file 2013       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. Irs e file 2013             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. Irs e file 2013 )         (Buyer) certifies the following under penalties of perjury:       Name of buyer         Buyer is a registered feedstock user with registration number . Irs e file 2013 Buyer's registration has not been revoked     or suspended. Irs e file 2013         The kerosene to which this certificate applies will be used by Buyer for a feedstock purpose. Irs e file 2013                 This certificate applies to percent of Buyer's purchases from (name, address, and employer     identification number of seller) as follows (complete as applicable):       1. Irs e file 2013 A single purchase on invoice or delivery ticket number . Irs e file 2013                 2. Irs e file 2013 All purchases between (effective date) and (expiration date) (period not to exceed     one year after the effective date) under account or order number(s) . Irs e file 2013 If this certificate applies only to Buyer's     purchases for certain locations, check here and list the locations. Irs e file 2013                                   If Buyer sells the kerosene to which this certificate relates, Buyer will be liable for tax on that sale. Irs e file 2013                 Buyer will provide a new certificate to the seller if any information in this certificate changes. Irs e file 2013                 If Buyer violates the terms of this certificate, the Internal Revenue Service may revoke the Buyer's registration. Irs e file 2013                 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. Irs e file 2013             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. Irs e file 2013 )                                         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. Irs e file 2013       This certificate applies to the following (complete as applicable):               If this is a single purchase certificate, check here and enter:       1. Irs e file 2013 Invoice or delivery ticket number       2. Irs e file 2013 (Gasoline gallon equivalents)       If this is a certificate covering all purchases under a specified account or order number, check here and enter:         1. Irs e file 2013 Effective date         2. Irs e file 2013 Expiration date         (period not to exceed 1 year after the effective date)         3. Irs e file 2013 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. Irs e file 2013       Buyer will provide a new certificate to the seller if any information in this certificate changes. Irs e file 2013       Buyer understands that if Buyer violates the terms of this certificate, the Internal Revenue Service may withdraw Buyer's     right to provide a certificate. Irs e file 2013       Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. Irs e file 2013     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. Irs e file 2013       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. Irs e file 2013             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. Irs e file 2013 )           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). Irs e file 2013       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. Irs e file 2013 Buyer's registration has not been suspended or revoked by the Internal Revenue Service. Irs e file 2013       This certificate applies to the following (complete as applicable):     This is a single purchase certificate:       1. Irs e file 2013 Invoice or delivery ticket number       2. Irs e file 2013 Number of gallons     This is a certificate covering all purchases under a specified account or order number:       1. Irs e file 2013 Effective date       2. Irs e file 2013 Expiration date (period not to exceed 1 year after the effective date)       3. Irs e file 2013 Buyer's account number       Buyer agrees to provide the person liable for tax with a new certificate if any information in this certificate changes. Irs e file 2013       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. Irs e file 2013       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. Irs e file 2013       Buyer understands that it must be prepared to establish by satisfactory evidence the purpose for which the     fuel purchased under this certificate was used. Irs e file 2013     Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. Irs e file 2013     If Buyer violates the terms of this certificate, the Internal Revenue Service may withdraw Buyer's right to provide a certificate. Irs e file 2013       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. Irs e file 2013           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. Irs e file 2013 )               Name, Address, and Employer Identification Number of Ultimate Vendor     The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under penalties of perjury:     A. Irs e file 2013 The kerosene to which this waiver relates is purchased for — (check one):       1. Irs e file 2013 □ Use on a farm for farming purposes,       2. Irs e file 2013 □ Use in foreign trade (reciprocal benefits required for foreign registered airlines),       3. Irs e file 2013 □ Use in certain helicopter and fixed-wing air ambulance uses,       4. Irs e file 2013 □ The exclusive use of a qualified blood collector organization,       5. Irs e file 2013 □ The exclusive use of a nonprofit educational organization,       6. Irs e file 2013 □ Use in an aircraft owned by an aircraft museum,       7. Irs e file 2013 □ Use in military aircraft, or       8. Irs e file 2013 □ Use in commercial aviation (other than foreign trade). Irs e file 2013     B. Irs e file 2013 This waiver applies to the following (complete as applicable):       This is a single purchase waiver:           1. Irs e file 2013 Invoice or delivery ticket number           2. Irs e file 2013 Number of gallons       This is a waiver covering all purchases under a specified account or order number:           1. Irs e file 2013 Effective date           2. Irs e file 2013 Expiration date (period not to exceed 1 year after the effective date)           3. Irs e file 2013 Buyer's account number       Buyer will provide a new waiver to the vendor if any information in this waiver changes. Irs e file 2013       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. Irs e file 2013       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. Irs e file 2013       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. Irs e file 2013       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. Irs e file 2013           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. Irs e file 2013 )                       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. Irs e file 2013       This certificate applies to the following (complete as applicable):     This is a single purchase certificate:       1. Irs e file 2013 Invoice or delivery ticket number       2. Irs e file 2013 Number of gallons     This is a certificate covering all purchases under a specified account or order number:       1. Irs e file 2013 Effective date       2. Irs e file 2013 Expiration date (period not to exceed 1 year after the effective date)       3. Irs e file 2013 Buyer's account number       Buyer will provide a new certificate to the vendor if any information in this certificate changes. Irs e file 2013       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. Irs e file 2013       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. Irs e file 2013       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. Irs e file 2013           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. Irs e file 2013 )                       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. Irs e file 2013       This waiver applies to the following (complete as applicable):     This is a single purchase waiver:       1. Irs e file 2013 Invoice or delivery ticket number       2. Irs e file 2013 Number of gallons     This is a waiver covering all purchases under a specified account or order number:       1. Irs e file 2013 Effective date       2. Irs e file 2013 Expiration date (period not to exceed 1 year after the effective date)       3. Irs e file 2013 Buyer's account number       Buyer will provide a new waiver to the vendor if any information in this waiver changes. Irs e file 2013       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. Irs e file 2013       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. Irs e file 2013       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. Irs e file 2013       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. Irs e file 2013           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. Irs e file 2013 )     The undersigned biodiesel producer (“Producer”) hereby certifies the following under penalties of perjury:   1. Irs e file 2013             Producer's name, address, and employer identification number (EIN)   2. Irs e file 2013             Name, address, and EIN of person buying the biodiesel from Producer   3. Irs e file 2013       Date and location of sale to buyer   4. Irs e file 2013 This certificate applies to gallons of biodiesel. Irs e file 2013   5. Irs e file 2013 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. Irs e file 2013             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. Irs e file 2013 Original Certificate Identification Number (only in the case of certificates reissued to a reseller after return of the original certificate). Irs e file 2013       Producer is registered as a biodiesel producer with registration number . Irs e file 2013  Producer's registration has not been suspended or revoked by the Internal Revenue Service. Irs e file 2013       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. Irs e file 2013 S. Irs e file 2013 C. Irs e file 2013 7545). Irs e file 2013       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. Irs e file 2013           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. Irs e file 2013 )               Name, Address, and Employer Identification Number of Vendor     The undersigned buyer (“Buyer”) hereby certifies the following under penalties of perjury:     A. Irs e file 2013 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. Irs e file 2013     B. Irs e file 2013 This certificate applies to the following (complete as applicable):       1. Irs e file 2013   If this is a single purchase certificate, check here □ and enter:           a. Irs e file 2013 Invoice or delivery ticket number           b. Irs e file 2013 Number of gallons       2. Irs e file 2013   If this is a certificate covering all purchases under a specified account or order number, check here □  and enter:           a. Irs e file 2013 Effective date           b. Irs e file 2013 Expiration date   (period not to exceed 1 year after effective date)           c. Irs e file 2013 Buyer's account or order number     ▪ Buyer will provide a new certificate to the vendor if any information in this certificate changes. Irs e file 2013     ▪ 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. Irs e file 2013     ▪ 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. Irs e file 2013     ▪ 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. Irs e file 2013           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. Irs e file 2013 )               Name, Address, and Employer Identification Number of Ultimate Vendor     The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under penalties of perjury:     A. Irs e file 2013 The kerosene to which this certificate relates is purchased for a nonexempt use in noncommercial aviation. Irs e file 2013     B. Irs e file 2013 This certificate applies to the following (complete as applicable):       1. Irs e file 2013   If this is a single purchase certificate, check here □ and enter:           a. Irs e file 2013 Invoice or delivery ticket number           b. Irs e file 2013 Number of gallons       2. Irs e file 2013   This is a certificate covering all purchases under a specified account or order number:           a. Irs e file 2013 Effective date           b. Irs e file 2013 Expiration date   (period not to exceed 1 year after effective date)           c. Irs e file 2013 Buyer's account number     ▪ Buyer will provide a new certificate to the vendor if any information in this certificate changes. Irs e file 2013     ▪ 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. Irs e file 2013     ▪ 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. Irs e file 2013           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. Irs e file 2013 )               Name, Address, and Employer Identification Number of Credit Card Issuer. Irs e file 2013     The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under penalties of perjury:     A. Irs e file 2013 Buyer will use the taxable fuel to which this certificate relates for the exclusive use of a state; or     B. Irs e file 2013 Buyer will use the gasoline to which this certificate relates for the exclusive use of a nonprofit educational organization. Irs e file 2013     C. Irs e file 2013 This certificate applies to all purchases made with the credit card identified below during the period specified:           a. Irs e file 2013 Effective date of certificate           b. Irs e file 2013 Expiration date of certificate   (period not to exceed 2 years after effective date)           c. Irs e file 2013 Buyer's account number     ▪ Buyer will provide a new certificate to the credit card issuer if any information in this certificate changes. Irs e file 2013     ▪ 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. Irs e file 2013     ▪ 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. Irs e file 2013     ▪ 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. Irs e file 2013           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. Irs e file 2013 )     The undersigned biodiesel producer (“Reseller”) hereby certifies the following under penalties of perjury:   1. Irs e file 2013                   Reseller's name, address, and employer identification number (EIN)   2. Irs e file 2013                   Name, address, and EIN of Reseller's buyer   3. Irs e file 2013       Date and location of sale to buyer   4. Irs e file 2013 Volume of biodiesel sold   5. Irs e file 2013 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. Irs e file 2013       Reseller has not been notified by the Internal Revenue Service that its right to provide a certificate or statement has been withdrawn. Irs e file 2013       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. Irs e file 2013           Printed or typed name of person signing this certificate           Title of person signing           Signature and date signed   Prev  Up  Next   Home   More Online Publications