Form YG3161 "Fuel Oil Tax - Application 5a" - Yukon, Canada

ADVERTISEMENT
ADVERTISEMENT

Download Form YG3161 "Fuel Oil Tax - Application 5a" - Yukon, Canada

Download PDF

Fill PDF online

Rate (4.3 / 5) 6 votes
Page background image
F .O.T. APPLICATION 5A
FUEL OIL T AX ACT
Finance
PURCHASE OF FUEL OIL T AX EXEMPT
FOR COMMERCIAL ACTIVITY - OFF-ROAD USE ONLY
COMMERCIAL ACTIVITY
(please circle applicable commercial activity and attach supporting documentation)
Activity Type
Supporting Documentation
A - Farming
- Current Property Assessment
F - Fishing
- Commercial Fishing Licence
L - Logging
- Timber Permit
M - Mining
- Claim Documents or Water Licence
H - Outfitting
- Outfitting Operating Certificate
S - Sawmill
- Business Licence
T - Trapping
- Trapping Licence
W - Tourism
- Wilderness Tourism Licence
1. Name of applicant
__________________________________
(legal name of business organization, proprietor or partners)
______________________________________________________________________________________________________
2. Registered trade name – if applicable
_________________________________________________
(Doing Business As)
3. Activity location, size and product ____________________________________________________________________
4. Operating season
from ______________________________ to __________________________________
(in months)
5. Mailing address of activity location ___________________________________________________________________
______________________________________________________________________________________________________
6. Permanent address
__________________________________________________________________
(if different from 5)
______________________________________________________________________________________________________
7. Telephone ________________________ Fax __________________________Email _____________________________
8. Details of off-road equipment used in eligible commercial activity
(Briefly describe the purpose of each piece of off-road equipment; attach another list if more space is required.)
ANTICIPATED
CONSUMPTION
FUEL TYPE:
MAKE/MODEL/YEAR
SERIAL NUMBER
Gas or Diesel
OF FUEL (LITRES)
PER SEASON/YEAR
1.
Purpose:
2.
Purpose:
3.
Purpose:
4.
Purpose:
5.
Purpose:
6.
Purpose:
7.
Purpose:
8.
Purpose:
Formulaire disponible en français
YG(3161EQ)F2 Rev 02/2013
F .O.T. APPLICATION 5A
FUEL OIL T AX ACT
Finance
PURCHASE OF FUEL OIL T AX EXEMPT
FOR COMMERCIAL ACTIVITY - OFF-ROAD USE ONLY
COMMERCIAL ACTIVITY
(please circle applicable commercial activity and attach supporting documentation)
Activity Type
Supporting Documentation
A - Farming
- Current Property Assessment
F - Fishing
- Commercial Fishing Licence
L - Logging
- Timber Permit
M - Mining
- Claim Documents or Water Licence
H - Outfitting
- Outfitting Operating Certificate
S - Sawmill
- Business Licence
T - Trapping
- Trapping Licence
W - Tourism
- Wilderness Tourism Licence
1. Name of applicant
__________________________________
(legal name of business organization, proprietor or partners)
______________________________________________________________________________________________________
2. Registered trade name – if applicable
_________________________________________________
(Doing Business As)
3. Activity location, size and product ____________________________________________________________________
4. Operating season
from ______________________________ to __________________________________
(in months)
5. Mailing address of activity location ___________________________________________________________________
______________________________________________________________________________________________________
6. Permanent address
__________________________________________________________________
(if different from 5)
______________________________________________________________________________________________________
7. Telephone ________________________ Fax __________________________Email _____________________________
8. Details of off-road equipment used in eligible commercial activity
(Briefly describe the purpose of each piece of off-road equipment; attach another list if more space is required.)
ANTICIPATED
CONSUMPTION
FUEL TYPE:
MAKE/MODEL/YEAR
SERIAL NUMBER
Gas or Diesel
OF FUEL (LITRES)
PER SEASON/YEAR
1.
Purpose:
2.
Purpose:
3.
Purpose:
4.
Purpose:
5.
Purpose:
6.
Purpose:
7.
Purpose:
8.
Purpose:
Formulaire disponible en français
YG(3161EQ)F2 Rev 02/2013
9. The Fuel Oil Tax Act Section 6(3) limits the issuance of tax exempt permits to those eligible commercial activities
conducted with the intention of earning income.
a) Is your business actively engaged in commercial operations (earning revenue)? _____ Yes
_____ No
b) Does your business intend to earn income (profit)? _____ Yes _____ No
c) What was your business income (profit) in the last fiscal year? ________________________________________
(retain financial statements for review by auditors)
d) What do you forecast your business income (profit) to be during this current fiscal year? ___________________
(retain business plan for review by auditors)
e) Should the answer to c or d (above) be a negative figure, please explain how the business intends to earn
income (profit).
_________________________________________________________________________________________________
f) Is greater than 50% of revenue derived from non-arm’s length (related or affiliated) customer?
_____ Yes
_____ No
If Yes, provide details: ______________________________________________________
10. Any exempt fuel purchased may only be used for eligible off-road operations as described in the Fuel Oil Tax
Act. Fuel purchase and consumption records must be maintained in sufficient detail so that exempt and taxable
fuel can be tracked separately.
a) Is there a separate storage tank for fuel purchased for exempt use?
_____ Yes
_____ No
If Yes, what size is the tank? ________________________________________________
b) Describe how you will track your exempt and taxable fuel volumes.
_________________________________________________________________________________________________
11. List other commercial activities in which you are involved.
______________________________________________
12. Fuel suppliers
(list all suppliers within Yukon as well as outside of Yukon, if applicable)
NAME
LOCATION
13. Declaration
I, _______________________________________ , _____________________________________ as a duly authorized
Print name
Print title
officer of ______________________________________________________________________________________________
Print company name
hereby certify, that the information contained in this application is correct to the best of my knowledge and belief
and hereby make application as required under the Fuel Oil Tax Act and undertake to comply with the provisions of
this Act and the Regulations thereunder.
__________________________________________________
_____________________________________________
Signature
Date
__________________________________________________
_____________________________________________
Signature
Date
For inquiries call Taxation at (867) 667-5345
Submit this application via:
Mail:
Government of Yukon
or
Email: yk.taxreturns@gov.yk.ca
Department of Finance, Taxation
or
Fax:
(867) 456-6709
Box 2703, Whitehorse,
Yukon, Y1A 2C6
The personal information requested on this form is collected under the authority of and used for the purpose of administering the Fuel Oil Tax Act.
Questions about the collection or use of this information can be directed to the Yukon Department of Finance, Box 2703, Whitehorse, Yukon, Y1A 2C6,
(867) 667-5343.
Page of 2