Form YG5802 "Fuel Oil Tax - Application 5b" - Yukon, Canada

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F.O.T. APPLICATION 5B
FUEL OIL TAX ACT
Finance
PURCHASE OF FUEL OIL TAX EXEMPT
FOR GENERATORS
ACTIVITY: G – Stationary Generator
SUPPORTING DOCUMENTATION: Current Property Assessment
1. Name of applicant
(if business provide legal name of business, proprietor or partners)
____________________________________________________________________________________________________
2. Registered trade name – if applicable
__________________________________________________
(doing business as)
3. Location of Generator ________________________________________________________________________________
4. Operating season
From ______________________________ to ___________________________________
(in months)
5. Mailing address _____________________________________________________________________________________
____________________________________________________________________________________________________
6. Permanent address
___________________________________________________________________
(if different from 5)
____________________________________________________________________________________________________
7. Telephone ______________________ Fax ___________________________Email_______________________________
8. Generator(s) details:
(Briefly describe the purpose of each generator; attach another list if more space is required.)
ANTICIPATED
FUEL TYPE:
CONSUMPTION
MAKE/MODEL/YEAR
SERIAL NUMBER
Gas or Diesel
OF FUEL (LITRES)
PER SEASON/YEAR
1.
Purpose:
2.
Purpose:
3.
Purpose:
4.
Purpose:
9. The Fuel Oil Tax Act Section 6(1) states that tax exempt permits may be issued for stationary generators of
electricity. These generator permits may be issued only if the generator meets certain criteria as assessed by the
following questions:
a) Is the generator(s) stationary? _____ Yes _____ No
b) Is the generator(s) permanently located on land or in a building? _____ Yes _____ No
c) Is the generator(s) intended to remain so located? _____ Yes _____ No
d) Is the generator(s) used for temporary service work? _____ Yes _____ No
e) Is the generator used for the temporary supply of electricity? _____ Yes _____ No
Formulaire disponible en français
YG(5802EQ)F2 Rev 12/2011
F.O.T. APPLICATION 5B
FUEL OIL TAX ACT
Finance
PURCHASE OF FUEL OIL TAX EXEMPT
FOR GENERATORS
ACTIVITY: G – Stationary Generator
SUPPORTING DOCUMENTATION: Current Property Assessment
1. Name of applicant
(if business provide legal name of business, proprietor or partners)
____________________________________________________________________________________________________
2. Registered trade name – if applicable
__________________________________________________
(doing business as)
3. Location of Generator ________________________________________________________________________________
4. Operating season
From ______________________________ to ___________________________________
(in months)
5. Mailing address _____________________________________________________________________________________
____________________________________________________________________________________________________
6. Permanent address
___________________________________________________________________
(if different from 5)
____________________________________________________________________________________________________
7. Telephone ______________________ Fax ___________________________Email_______________________________
8. Generator(s) details:
(Briefly describe the purpose of each generator; attach another list if more space is required.)
ANTICIPATED
FUEL TYPE:
CONSUMPTION
MAKE/MODEL/YEAR
SERIAL NUMBER
Gas or Diesel
OF FUEL (LITRES)
PER SEASON/YEAR
1.
Purpose:
2.
Purpose:
3.
Purpose:
4.
Purpose:
9. The Fuel Oil Tax Act Section 6(1) states that tax exempt permits may be issued for stationary generators of
electricity. These generator permits may be issued only if the generator meets certain criteria as assessed by the
following questions:
a) Is the generator(s) stationary? _____ Yes _____ No
b) Is the generator(s) permanently located on land or in a building? _____ Yes _____ No
c) Is the generator(s) intended to remain so located? _____ Yes _____ No
d) Is the generator(s) used for temporary service work? _____ Yes _____ No
e) Is the generator used for the temporary supply of electricity? _____ Yes _____ No
Formulaire disponible en français
YG(5802EQ)F2 Rev 12/2011
10. Any exempt fuel purchased may only be used for eligible stationary electrical generators 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. Fuel suppliers
(list all suppliers within Yukon as well as outside of Yukon, if applicable)
NAME
LOCATION
12. 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.
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