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Manufacturing Certiﬁcation for

New York State

FT-1012

Department of

Diesel Motor Fuel and

(1/98)

Taxation

and Finance

Residual Petroleum Product

To Sellers:

Your sales are subject to the

applicable taxes on diesel motor

To Purchasers and Sellers:

fuel or residual petroleum product

Read certiﬁcations carefully before

unless the purchaser gives you a

properly completed certiﬁcation at

giving or accepting this certiﬁcate.

or before the time of delivery. Keep

The purchaser must complete this certiﬁcate and give it to the seller. Please type or print.

the certiﬁcate for at least three years.

Name of vendor

Name of purchaser

Street address

City

State

ZIP code

City

State

ZIP code

Enter speciﬁc product type

and check applicable box:

□ Single-purchase certiﬁcate. Enter invoice or delivery ticket number

and number of gallons

□ Blanket certiﬁcate. This certiﬁcate will be considered part of any order given to you and will remain in force until revoked

by written notice. It covers only purchases of the speciﬁc product type listed below. (Use a separate Form FT-1012 for

each product type.)

Diesel Motor Fuel

(d) I certify that

% of the fuel is to be used for

residential heating purposes. (This sale is exempt from the

(a) I certify that all (100%) of the unenhanced diesel motor fuel

petroleum business tax, diesel motor fuel tax and the New York

covered by this certiﬁcate is being delivered to the manufacturing

State sales tax but, if applicable, subject to local sales tax).

site for use directly and exclusively in the production of tangible

(e) I certify that

% of the fuel is to be used for any

personal property for sale, by manufacturing, processing or

other purpose (except on the highways of this state) than that

assembly, and will not be consumed on the highways of this

stated above. (This sale is subject to the petroleum business tax

state. The fuel will not be delivered to a ﬁlling station or a tank

at the automotive rate, the diesel motor fuel tax and the New

equipped with a nozzle or other apparatus that can fuel a motor

York State and local sales taxes unless a valid exemption

vehicle. (This sale is exempt from the diesel motor fuel tax, the

document is completed and given to the supplier).

petroleum business tax, and the New York State and other local

sales taxes but, if fuel is delivered or used in New York City,

Residual Petroleum Product

subject to the 4% local sales tax.)

If less than 100% of the fuel is to be used for manufacturing

(a) I certify that all (100%) of the residual petroleum product

(as stated above) check the box below and indicate the

covered by this certiﬁcate is being delivered to the manufacturing

appropriate percentages of use. These percentages must

site for use directly and exclusively in the production of tangible

total 100%.

personal property for sale, by manufacturing, processing or

assembly, and will not be consumed on the highways of this

state. (This sale is exempt from the petroleum business tax and

(a) I certify that

% of the fuel is to be used in

the New York State and other local sales taxes but, if fuel is

the production of tangible personal property for sale as described

delivered or used in New York City, subject to the 4% local sales

above (must be supported by an engineering study).

tax.)

If less than 100% of the product is to be used for

manufacturing (as stated above) check the box below and

(b) I certify that

% of the fuel is to be used for

indicate the appropriate percentages of use. These

nonresidential (commercial) heating purposes. (This sale is

percentages must total 100%.

subject to the petroleum business tax at the commercial

gallonage rate for diesel motor fuel and the New York State and

(a) I certify that

% of the product is to be used in

local sales taxes, but exempt from the diesel motor fuel tax.)

the production of tangible personal property for sale as described

above (must be supported by an engineering study).

% of the fuel is to be used in the

(b) I certify that

% of the product is to be used for

production of (a) tangible personal property for sale, by reﬁning,

residential heating purposes. (This sale is exempt from the

extracting or mining or (b) gas, electricity (except if you are an

petroleum business tax and the New York State sales tax but, if

electric utility using the fuel in generators to produce electricity),

applicable, subject to local sales tax).

refrigeration or steam for sale. The fuel will not be delivered to a

ﬁlling station or a storage tank equipped with a nozzle or other

% of the product is to be used for

apparatus that can fuel a motor vehicle or be used on the

any other purposes than that stated above except if you are an

highways of this state. (This sale is subject to the petroleum

electric utility using the product in generators to produce

business tax at the commercial gallonage rate for diesel motor

electricity. (This sale is subject to the petroleum business tax at

fuel and, if delivered or used in New York City, the 4% local sales

the commercial gallonage rate for residual petroleum product and

tax, but exempt from the diesel motor fuel tax and the New York

to the New York State and local sales taxes unless a valid

State and other local sales taxes.)

exemption document is completed and given to the supplier).

Note: Kerosene is exempt from the petroleum business tax when sold by a petroleum business registered as a Distributor of Diesel

Motor Fuel or a Retailer of Heating Oil Only and the kerosene is not mixed or blended with other products, is not sold in conjunction

with any other petroleum product, or is not sold or used to operate motor vehicles.

I certify that the diesel motor fuel or residual petroleum product being purchased will be used as indicated.

Signature of purchaser or authorized representative

Title

Date

Any person who attempts to use this certiﬁcate to evade taxes due on diesel motor fuel or residual petroleum product will be subject to

penalties under the NYS Tax Law.

Form Ft-1012 - Manufacturing Certification For Diesel Motor Fuel And Residual Petroleum Product

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