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Www myfreetaxes com upstreetfreetax 18. Www myfreetaxes com upstreetfreetax   Appendix This appendix contains models of the certificates, waivers, reports, and statements discussed in Part One. Www myfreetaxes com upstreetfreetax Model Certificate A   STATEMENT OF SUBSEQUENT SELLER     1. Www myfreetaxes com upstreetfreetax                 Name, address, and employer identification number of seller in subsequent sale             2. Www myfreetaxes com upstreetfreetax                 Name, address, and employer identification number of the buyer in subsequent sale             3. Www myfreetaxes com upstreetfreetax         Date and location of subsequent sale             4. Www myfreetaxes com upstreetfreetax         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. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax                   Signature and date signed                   Printed or typed name of person signing this report                   Title—   Model Certificate B   FIRST TAXPAYER'S REPORT   1. Www myfreetaxes com upstreetfreetax                     First Taxpayer's name, address and employer identification number     2. Www myfreetaxes com upstreetfreetax                     Name, address, and employer identification number of the buyer of the taxable fuel subject to tax     3. Www myfreetaxes com upstreetfreetax           Date and location of removal, entry, or sale       4. Www myfreetaxes com upstreetfreetax           Volume and type of taxable fuel removed, entered or sold     5. Www myfreetaxes com upstreetfreetax 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. Www myfreetaxes com upstreetfreetax           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. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax             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. Www myfreetaxes com upstreetfreetax                 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. Www myfreetaxes com upstreetfreetax                       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. Www myfreetaxes com upstreetfreetax )                 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. Www myfreetaxes com upstreetfreetax       This certificate applies to the following (complete as applicable):       If this is a single purchase certificate, check here and enter:     1. Www myfreetaxes com upstreetfreetax Invoice or delivery ticket number       2. Www myfreetaxes com upstreetfreetax (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. Www myfreetaxes com upstreetfreetax Effective date       2. Www myfreetaxes com upstreetfreetax Expiration date       (period not to exceed 1 year after the effective date)       3. Www myfreetaxes com upstreetfreetax Type (or types) of gasoline blendstocks     4. Www myfreetaxes com upstreetfreetax 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. Www myfreetaxes com upstreetfreetax         Buyer will provide a new certificate to the seller if any information in this certificate changes. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax 4081-4(b)(3) of the Manufacturers and Retailers Excise Tax Regulations. Www myfreetaxes com upstreetfreetax       Buyer understands that if Buyer violates the terms of this certificate, the Internal Revenue Service may withdraw Buyer's     right to provide a certificate. Www myfreetaxes com upstreetfreetax       Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. Www myfreetaxes com upstreetfreetax     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. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax             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. Www myfreetaxes com upstreetfreetax )         (Buyer) certifies the following under penalties of perjury:       Name of buyer         Buyer is a registered feedstock user with registration number . Www myfreetaxes com upstreetfreetax Buyer's registration has not been revoked     or suspended. Www myfreetaxes com upstreetfreetax         The kerosene to which this certificate applies will be used by Buyer for a feedstock purpose. Www myfreetaxes com upstreetfreetax                 This certificate applies to percent of Buyer's purchases from (name, address, and employer     identification number of seller) as follows (complete as applicable):       1. Www myfreetaxes com upstreetfreetax A single purchase on invoice or delivery ticket number . Www myfreetaxes com upstreetfreetax                 2. Www myfreetaxes com upstreetfreetax All purchases between (effective date) and (expiration date) (period not to exceed     one year after the effective date) under account or order number(s) . Www myfreetaxes com upstreetfreetax If this certificate applies only to Buyer's     purchases for certain locations, check here and list the locations. Www myfreetaxes com upstreetfreetax                                   If Buyer sells the kerosene to which this certificate relates, Buyer will be liable for tax on that sale. Www myfreetaxes com upstreetfreetax                 Buyer will provide a new certificate to the seller if any information in this certificate changes. Www myfreetaxes com upstreetfreetax                 If Buyer violates the terms of this certificate, the Internal Revenue Service may revoke the Buyer's registration. Www myfreetaxes com upstreetfreetax                 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. Www myfreetaxes com upstreetfreetax             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. Www myfreetaxes com upstreetfreetax )                                         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. Www myfreetaxes com upstreetfreetax       This certificate applies to the following (complete as applicable):               If this is a single purchase certificate, check here and enter:       1. Www myfreetaxes com upstreetfreetax Invoice or delivery ticket number       2. Www myfreetaxes com upstreetfreetax (Gasoline gallon equivalents)       If this is a certificate covering all purchases under a specified account or order number, check here and enter:         1. Www myfreetaxes com upstreetfreetax Effective date         2. Www myfreetaxes com upstreetfreetax Expiration date         (period not to exceed 1 year after the effective date)         3. Www myfreetaxes com upstreetfreetax 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. Www myfreetaxes com upstreetfreetax       Buyer will provide a new certificate to the seller if any information in this certificate changes. Www myfreetaxes com upstreetfreetax       Buyer understands that if Buyer violates the terms of this certificate, the Internal Revenue Service may withdraw Buyer's     right to provide a certificate. Www myfreetaxes com upstreetfreetax       Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. Www myfreetaxes com upstreetfreetax     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. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax             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. Www myfreetaxes com upstreetfreetax )           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). Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax Buyer's registration has not been suspended or revoked by the Internal Revenue Service. Www myfreetaxes com upstreetfreetax       This certificate applies to the following (complete as applicable):     This is a single purchase certificate:       1. Www myfreetaxes com upstreetfreetax Invoice or delivery ticket number       2. Www myfreetaxes com upstreetfreetax Number of gallons     This is a certificate covering all purchases under a specified account or order number:       1. Www myfreetaxes com upstreetfreetax Effective date       2. Www myfreetaxes com upstreetfreetax Expiration date (period not to exceed 1 year after the effective date)       3. Www myfreetaxes com upstreetfreetax Buyer's account number       Buyer agrees to provide the person liable for tax with a new certificate if any information in this certificate changes. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax       Buyer understands that it must be prepared to establish by satisfactory evidence the purpose for which the     fuel purchased under this certificate was used. Www myfreetaxes com upstreetfreetax     Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. Www myfreetaxes com upstreetfreetax     If Buyer violates the terms of this certificate, the Internal Revenue Service may withdraw Buyer's right to provide a certificate. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax           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. Www myfreetaxes com upstreetfreetax )               Name, Address, and Employer Identification Number of Ultimate Vendor     The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under penalties of perjury:     A. Www myfreetaxes com upstreetfreetax The kerosene to which this waiver relates is purchased for — (check one):       1. Www myfreetaxes com upstreetfreetax □ Use on a farm for farming purposes,       2. Www myfreetaxes com upstreetfreetax □ Use in foreign trade (reciprocal benefits required for foreign registered airlines),       3. Www myfreetaxes com upstreetfreetax □ Use in certain helicopter and fixed-wing air ambulance uses,       4. Www myfreetaxes com upstreetfreetax □ The exclusive use of a qualified blood collector organization,       5. Www myfreetaxes com upstreetfreetax □ The exclusive use of a nonprofit educational organization,       6. Www myfreetaxes com upstreetfreetax □ Use in an aircraft owned by an aircraft museum,       7. Www myfreetaxes com upstreetfreetax □ Use in military aircraft, or       8. Www myfreetaxes com upstreetfreetax □ Use in commercial aviation (other than foreign trade). Www myfreetaxes com upstreetfreetax     B. Www myfreetaxes com upstreetfreetax This waiver applies to the following (complete as applicable):       This is a single purchase waiver:           1. Www myfreetaxes com upstreetfreetax Invoice or delivery ticket number           2. Www myfreetaxes com upstreetfreetax Number of gallons       This is a waiver covering all purchases under a specified account or order number:           1. Www myfreetaxes com upstreetfreetax Effective date           2. Www myfreetaxes com upstreetfreetax Expiration date (period not to exceed 1 year after the effective date)           3. Www myfreetaxes com upstreetfreetax Buyer's account number       Buyer will provide a new waiver to the vendor if any information in this waiver changes. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax           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. Www myfreetaxes com upstreetfreetax )                       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. Www myfreetaxes com upstreetfreetax       This certificate applies to the following (complete as applicable):     This is a single purchase certificate:       1. Www myfreetaxes com upstreetfreetax Invoice or delivery ticket number       2. Www myfreetaxes com upstreetfreetax Number of gallons     This is a certificate covering all purchases under a specified account or order number:       1. Www myfreetaxes com upstreetfreetax Effective date       2. Www myfreetaxes com upstreetfreetax Expiration date (period not to exceed 1 year after the effective date)       3. Www myfreetaxes com upstreetfreetax Buyer's account number       Buyer will provide a new certificate to the vendor if any information in this certificate changes. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax           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. Www myfreetaxes com upstreetfreetax )                       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. Www myfreetaxes com upstreetfreetax       This waiver applies to the following (complete as applicable):     This is a single purchase waiver:       1. Www myfreetaxes com upstreetfreetax Invoice or delivery ticket number       2. Www myfreetaxes com upstreetfreetax Number of gallons     This is a waiver covering all purchases under a specified account or order number:       1. Www myfreetaxes com upstreetfreetax Effective date       2. Www myfreetaxes com upstreetfreetax Expiration date (period not to exceed 1 year after the effective date)       3. Www myfreetaxes com upstreetfreetax Buyer's account number       Buyer will provide a new waiver to the vendor if any information in this waiver changes. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax           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. Www myfreetaxes com upstreetfreetax )     The undersigned biodiesel producer (“Producer”) hereby certifies the following under penalties of perjury:   1. Www myfreetaxes com upstreetfreetax             Producer's name, address, and employer identification number (EIN)   2. Www myfreetaxes com upstreetfreetax             Name, address, and EIN of person buying the biodiesel from Producer   3. Www myfreetaxes com upstreetfreetax       Date and location of sale to buyer   4. Www myfreetaxes com upstreetfreetax This certificate applies to gallons of biodiesel. Www myfreetaxes com upstreetfreetax   5. Www myfreetaxes com upstreetfreetax 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. Www myfreetaxes com upstreetfreetax             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. Www myfreetaxes com upstreetfreetax Original Certificate Identification Number (only in the case of certificates reissued to a reseller after return of the original certificate). Www myfreetaxes com upstreetfreetax       Producer is registered as a biodiesel producer with registration number . Www myfreetaxes com upstreetfreetax  Producer's registration has not been suspended or revoked by the Internal Revenue Service. Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax S. Www myfreetaxes com upstreetfreetax C. Www myfreetaxes com upstreetfreetax 7545). Www myfreetaxes com upstreetfreetax       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. Www myfreetaxes com upstreetfreetax           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. Www myfreetaxes com upstreetfreetax )               Name, Address, and Employer Identification Number of Vendor     The undersigned buyer (“Buyer”) hereby certifies the following under penalties of perjury:     A. Www myfreetaxes com upstreetfreetax 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. Www myfreetaxes com upstreetfreetax     B. Www myfreetaxes com upstreetfreetax This certificate applies to the following (complete as applicable):       1. Www myfreetaxes com upstreetfreetax   If this is a single purchase certificate, check here □ and enter:           a. Www myfreetaxes com upstreetfreetax Invoice or delivery ticket number           b. Www myfreetaxes com upstreetfreetax Number of gallons       2. Www myfreetaxes com upstreetfreetax   If this is a certificate covering all purchases under a specified account or order number, check here □  and enter:           a. Www myfreetaxes com upstreetfreetax Effective date           b. Www myfreetaxes com upstreetfreetax Expiration date   (period not to exceed 1 year after effective date)           c. Www myfreetaxes com upstreetfreetax Buyer's account or order number     ▪ Buyer will provide a new certificate to the vendor if any information in this certificate changes. Www myfreetaxes com upstreetfreetax     ▪ 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. Www myfreetaxes com upstreetfreetax     ▪ 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. Www myfreetaxes com upstreetfreetax     ▪ 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. Www myfreetaxes com upstreetfreetax           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. Www myfreetaxes com upstreetfreetax )               Name, Address, and Employer Identification Number of Ultimate Vendor     The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under penalties of perjury:     A. Www myfreetaxes com upstreetfreetax The kerosene to which this certificate relates is purchased for a nonexempt use in noncommercial aviation. Www myfreetaxes com upstreetfreetax     B. Www myfreetaxes com upstreetfreetax This certificate applies to the following (complete as applicable):       1. Www myfreetaxes com upstreetfreetax   If this is a single purchase certificate, check here □ and enter:           a. Www myfreetaxes com upstreetfreetax Invoice or delivery ticket number           b. Www myfreetaxes com upstreetfreetax Number of gallons       2. Www myfreetaxes com upstreetfreetax   This is a certificate covering all purchases under a specified account or order number:           a. Www myfreetaxes com upstreetfreetax Effective date           b. Www myfreetaxes com upstreetfreetax Expiration date   (period not to exceed 1 year after effective date)           c. Www myfreetaxes com upstreetfreetax Buyer's account number     ▪ Buyer will provide a new certificate to the vendor if any information in this certificate changes. Www myfreetaxes com upstreetfreetax     ▪ 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. Www myfreetaxes com upstreetfreetax     ▪ 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. Www myfreetaxes com upstreetfreetax           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. Www myfreetaxes com upstreetfreetax )               Name, Address, and Employer Identification Number of Credit Card Issuer. Www myfreetaxes com upstreetfreetax     The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under penalties of perjury:     A. Www myfreetaxes com upstreetfreetax Buyer will use the taxable fuel to which this certificate relates for the exclusive use of a state; or     B. Www myfreetaxes com upstreetfreetax Buyer will use the gasoline to which this certificate relates for the exclusive use of a nonprofit educational organization. Www myfreetaxes com upstreetfreetax     C. Www myfreetaxes com upstreetfreetax This certificate applies to all purchases made with the credit card identified below during the period specified:           a. Www myfreetaxes com upstreetfreetax Effective date of certificate           b. Www myfreetaxes com upstreetfreetax Expiration date of certificate   (period not to exceed 2 years after effective date)           c. Www myfreetaxes com upstreetfreetax Buyer's account number     ▪ Buyer will provide a new certificate to the credit card issuer if any information in this certificate changes. Www myfreetaxes com upstreetfreetax     ▪ 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. Www myfreetaxes com upstreetfreetax     ▪ 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. Www myfreetaxes com upstreetfreetax     ▪ 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. Www myfreetaxes com upstreetfreetax           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. Www myfreetaxes com upstreetfreetax )     The undersigned biodiesel producer (“Reseller”) hereby certifies the following under penalties of perjury:   1. Www myfreetaxes com upstreetfreetax                   Reseller's name, address, and employer identification number (EIN)   2. Www myfreetaxes com upstreetfreetax                   Name, address, and EIN of Reseller's buyer   3. Www myfreetaxes com upstreetfreetax       Date and location of sale to buyer   4. Www myfreetaxes com upstreetfreetax Volume of biodiesel sold   5. Www myfreetaxes com upstreetfreetax 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. Www myfreetaxes com upstreetfreetax       Reseller has not been notified by the Internal Revenue Service that its right to provide a certificate or statement has been withdrawn. Www myfreetaxes com upstreetfreetax       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. 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Www myfreetaxes com upstreetfreetax Publication 504 - Introductory Material Table of Contents Future Developments Reminders IntroductionOrdering forms and publications. Www myfreetaxes com upstreetfreetax Tax questions. Www myfreetaxes com upstreetfreetax Useful Items - You may want to see: Future Developments For the latest information about developments related to Publication 504, such as legislation enacted after this publication was published, go to www. Www myfreetaxes com upstreetfreetax irs. Www myfreetaxes com upstreetfreetax gov/pub504. Www myfreetaxes com upstreetfreetax Reminders Relief from joint liability. Www myfreetaxes com upstreetfreetax  In some cases, one spouse may be relieved of joint liability for tax, interest, and penalties on a joint tax return. Www myfreetaxes com upstreetfreetax For more information, see Relief from joint liability under Married Filing Jointly. Www myfreetaxes com upstreetfreetax Social security numbers for dependents. Www myfreetaxes com upstreetfreetax  You must include on your tax return the taxpayer identification number (generally the social security number) of every person for whom you claim an exemption. Www myfreetaxes com upstreetfreetax See Exemptions for Dependents under Exemptions, later. Www myfreetaxes com upstreetfreetax Individual taxpayer identification number (ITIN). Www myfreetaxes com upstreetfreetax  The IRS will issue an ITIN to a nonresident or resident alien who does not have and is not eligible to get a social security number (SSN). Www myfreetaxes com upstreetfreetax To apply for an ITIN, file Form W-7, Application for IRS Individual Taxpayer Identification Number, with the IRS. Www myfreetaxes com upstreetfreetax It takes about 6 to 10 weeks to get an ITIN. Www myfreetaxes com upstreetfreetax The ITIN is entered wherever an SSN is requested on a tax return. Www myfreetaxes com upstreetfreetax If you are required to include another person's SSN on your return and that person does not have and cannot get an SSN, enter that person's ITIN. Www myfreetaxes com upstreetfreetax Change of address. Www myfreetaxes com upstreetfreetax  If you change your mailing address, be sure to notify the Internal Revenue Service. Www myfreetaxes com upstreetfreetax You can use Form 8822, Change of Address. Www myfreetaxes com upstreetfreetax Mail it to the Internal Revenue Service Center for your old address. Www myfreetaxes com upstreetfreetax (Addresses for the Service Centers are on the back of the form. Www myfreetaxes com upstreetfreetax ) Change of name. Www myfreetaxes com upstreetfreetax  If you change your name, be sure to notify the Social Security Administration using Form SS-5, Application for a Social Security Card. Www myfreetaxes com upstreetfreetax Change of withholding. Www myfreetaxes com upstreetfreetax  If you have been claiming a withholding exemption for your spouse, and you divorce or legally separate, you must give your employer a new Form W-4, Employee's Withholding Allowance Certificate, within 10 days after the divorce or separation showing the correct number of exemptions. Www myfreetaxes com upstreetfreetax Photographs of missing children. Www myfreetaxes com upstreetfreetax  The Internal Revenue Service is a proud partner with the National Center for Missing and Exploited Children. Www myfreetaxes com upstreetfreetax Photographs of missing children selected by the Center may appear in this publication on pages that would otherwise be blank. Www myfreetaxes com upstreetfreetax You can help bring these children home by looking at the photographs and calling 1-800-THE-LOST (1-800-843-5678) if you recognize a child. Www myfreetaxes com upstreetfreetax Introduction This publication explains tax rules that apply if you are divorced or separated from your spouse. Www myfreetaxes com upstreetfreetax It covers general filing information and can help you choose your filing status. Www myfreetaxes com upstreetfreetax It also can help you decide which exemptions you are entitled to claim, including exemptions for dependents. Www myfreetaxes com upstreetfreetax The publication also discusses payments and transfers of property that often occur as a result of divorce and how you must treat them on your tax return. Www myfreetaxes com upstreetfreetax Examples include alimony, child support, other court-ordered payments, property settlements, and transfers of individual retirement arrangements. Www myfreetaxes com upstreetfreetax In addition, this publication also explains deductions allowed for some of the costs of obtaining a divorce and how to handle tax withholding and estimated tax payments. Www myfreetaxes com upstreetfreetax The last part of the publication explains special rules that may apply to persons who live in community property states. Www myfreetaxes com upstreetfreetax Comments and suggestions. Www myfreetaxes com upstreetfreetax   We welcome your comments about this publication and your suggestions for future editions. Www myfreetaxes com upstreetfreetax   You can write to us at the following address: Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave. Www myfreetaxes com upstreetfreetax NW, IR-6526 Washington, DC 20224   We respond to many letters by telephone. Www myfreetaxes com upstreetfreetax Therefore, it would be helpful if you would include your daytime phone number, including the area code, in your correspondence. Www myfreetaxes com upstreetfreetax   You can send your comments from www. Www myfreetaxes com upstreetfreetax irs. Www myfreetaxes com upstreetfreetax gov/formspubs/. Www myfreetaxes com upstreetfreetax Click on “More Information. Www myfreetaxes com upstreetfreetax ”and then on “Comment on Tax Forms and Publications”. Www myfreetaxes com upstreetfreetax   Although we cannot respond individually to each comment received, we do appreciate your feedback and will consider your comments as we revise our tax products. Www myfreetaxes com upstreetfreetax Ordering forms and publications. Www myfreetaxes com upstreetfreetax   Visit www. Www myfreetaxes com upstreetfreetax irs. Www myfreetaxes com upstreetfreetax gov/formspubs/ to download forms and publications, call 1-800-TAX-FORM (1-800-829-3676), or write to the address below and receive a response within 10 days after your request is received. Www myfreetaxes com upstreetfreetax Internal Revenue Service 1201 N. Www myfreetaxes com upstreetfreetax Mitsubishi Motorway Bloomington, IL 61705-6613 Tax questions. Www myfreetaxes com upstreetfreetax   If you have a tax question, check the information available on IRS. Www myfreetaxes com upstreetfreetax gov or call 1-800-829-1040. Www myfreetaxes com upstreetfreetax We cannot answer tax questions sent to either of the above addresses. Www myfreetaxes com upstreetfreetax Useful Items - You may want to see: Publications 501 Exemptions, Standard Deduction, and Filing Information 544 Sales and Other Dispositions of Assets 555 Community Property 590 Individual Retirement Arrangements (IRAs) 971 Innocent Spouse Relief Form (and Instructions) 8332 Release/Revocation of Release of Claim to Exemption for Child by Custodial Parent 8379 Injured Spouse Allocation 8857 Request for Innocent Spouse Relief See How To Get Tax Help near the end of this publication for information about getting publications and forms. Www myfreetaxes com upstreetfreetax Prev  Up  Next   Home   More Online Publications