Form GA-IX "Motor Fuel Tax Importer Report" - New Jersey

What Is Form GA-IX?

This is a legal form that was released by the New Jersey Department of the Treasury - a government authority operating within New Jersey. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2001;
  • The latest edition provided by the New Jersey Department of the Treasury;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form GA-IX by clicking the link below or browse more documents and templates provided by the New Jersey Department of the Treasury.

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Download Form GA-IX "Motor Fuel Tax Importer Report" - New Jersey

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GA-IX
STATE OF NEW JERSEY
(Rev. 6-01)
DEPARTMENT OF THE TREASURY - DIVISION OF TAXATION
MONTH OF__________________, 20____
04
MOTOR FUEL TAX
THIS REPORT REQUIRED BY
LICENSE NO. ______________________
IMPORTER REPORT
N.J. MOTOR FUEL TAX LAW
Please print or type name and address exactly as it appears on License Certificate
This report must be filed on a monthly basis even if there has been no activity during the report
month. Please submit the tax due and the report, in DUPLICATE, to:
F.I.D. NO. ____________________________________________
DIVISION OF TAXATION - MOTOR FUEL TAX, PO BOX 243, TRENTON, NJ 08695-0243
Name of
on or before the 20th of the month following the report month.
Licensee _________________________________________________________________________
Make check payable to: STATE OF NEW JERSEY-MFT.
Address _________________________________________________________________________
Note: Negative returns should be indicated by writing “NONE” on lines 9, 10 and 17.
Address
County
State
Zip Code
REFER TO INSTRUCTIONS FOR REPORTING - USE REVERSE SIDE FOR ADDITIONAL SPACES.
A
B
C
D
E
F
G
Date
Line
Rec’d
Method of Delivery
Purchased From
Point of Shipment
Sold To
Point of Delivery
Gallons
1.
2.
3.
4.
5.
6.
7.
8.
Sub-total transferred from line 36 on reverse side . . . . . . . . . . . . . . . . . . . .
9. Total Gallons Imported - Gasoline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10. Total Gallons Imported - Gasoline (Line 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .____________________________
11. Previously Unreported Gallons (attach detail) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .____________________________
12. Total Gallons Imported (Line 10 plus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .____________________________
13. Gallons Sold to Government Agencies (Attach U.S. 1094 and C-6060-MF) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .____________________________
14. Gallons Sold to Licensed Distributors and Gasoline Jobbers (From Schedule GA-1B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .____________________________
15a Gallons Sold for Export (from Schedule GA-1B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .____________________________
15b Gallons Purchased Instate and Directly Exported (from Schedule GA-1B) (not a deduction) ___________________________
16. Gallons Taxable (Line 12 minus the sum of Lines 13, 14 and 15a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .___________________________
17. Gross Tax Due (Line 16 at current rate per gallon) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ ___________________________
18. Add: Airport Safety Tax (from Schedule GA-IV) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .___________________________
19. Add Penalty and Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .___________________________
20a Less Prior Month Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ ___________________________
20b Less Amount Paid with Estimated Return or Electronic Funds Transfer . . . . . . . . . . . . . . . .$ ___________________________
PAY THIS AMOUNT
21. Net Tax Due (Line 17 plus Lines 18 and 19 minus Lines 20a and 20b) . . . . . . . . . . . . . . . . .ENTER AMOUNT HERE
$ __________________________
The undersigned IMPORTER, UNDER THE PENALTIES OF PERJURY, states that all of the information contained in this report is true and accurate in every particular.
_________________________________________________________________________________________________________________________________________________________________________________________________________________
Signature
Title
Date
_________________________________________________________________________________________________________________________________________________________________________________________________________________
Signature of Individual or Firm Preparing Return
Federal ID Number
Telephone #
Date
GA-IX
STATE OF NEW JERSEY
(Rev. 6-01)
DEPARTMENT OF THE TREASURY - DIVISION OF TAXATION
MONTH OF__________________, 20____
04
MOTOR FUEL TAX
THIS REPORT REQUIRED BY
LICENSE NO. ______________________
IMPORTER REPORT
N.J. MOTOR FUEL TAX LAW
Please print or type name and address exactly as it appears on License Certificate
This report must be filed on a monthly basis even if there has been no activity during the report
month. Please submit the tax due and the report, in DUPLICATE, to:
F.I.D. NO. ____________________________________________
DIVISION OF TAXATION - MOTOR FUEL TAX, PO BOX 243, TRENTON, NJ 08695-0243
Name of
on or before the 20th of the month following the report month.
Licensee _________________________________________________________________________
Make check payable to: STATE OF NEW JERSEY-MFT.
Address _________________________________________________________________________
Note: Negative returns should be indicated by writing “NONE” on lines 9, 10 and 17.
Address
County
State
Zip Code
REFER TO INSTRUCTIONS FOR REPORTING - USE REVERSE SIDE FOR ADDITIONAL SPACES.
A
B
C
D
E
F
G
Date
Line
Rec’d
Method of Delivery
Purchased From
Point of Shipment
Sold To
Point of Delivery
Gallons
1.
2.
3.
4.
5.
6.
7.
8.
Sub-total transferred from line 36 on reverse side . . . . . . . . . . . . . . . . . . . .
9. Total Gallons Imported - Gasoline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10. Total Gallons Imported - Gasoline (Line 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .____________________________
11. Previously Unreported Gallons (attach detail) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .____________________________
12. Total Gallons Imported (Line 10 plus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .____________________________
13. Gallons Sold to Government Agencies (Attach U.S. 1094 and C-6060-MF) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .____________________________
14. Gallons Sold to Licensed Distributors and Gasoline Jobbers (From Schedule GA-1B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .____________________________
15a Gallons Sold for Export (from Schedule GA-1B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .____________________________
15b Gallons Purchased Instate and Directly Exported (from Schedule GA-1B) (not a deduction) ___________________________
16. Gallons Taxable (Line 12 minus the sum of Lines 13, 14 and 15a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .___________________________
17. Gross Tax Due (Line 16 at current rate per gallon) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ ___________________________
18. Add: Airport Safety Tax (from Schedule GA-IV) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .___________________________
19. Add Penalty and Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .___________________________
20a Less Prior Month Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ ___________________________
20b Less Amount Paid with Estimated Return or Electronic Funds Transfer . . . . . . . . . . . . . . . .$ ___________________________
PAY THIS AMOUNT
21. Net Tax Due (Line 17 plus Lines 18 and 19 minus Lines 20a and 20b) . . . . . . . . . . . . . . . . .ENTER AMOUNT HERE
$ __________________________
The undersigned IMPORTER, UNDER THE PENALTIES OF PERJURY, states that all of the information contained in this report is true and accurate in every particular.
_________________________________________________________________________________________________________________________________________________________________________________________________________________
Signature
Title
Date
_________________________________________________________________________________________________________________________________________________________________________________________________________________
Signature of Individual or Firm Preparing Return
Federal ID Number
Telephone #
Date
Reverse Side GA-IX
(Rev. 6-01)
STATE OF NEW JERSEY
Name of Licensee __________________________________________________________________________________________________________________________________________________
Report Month _____________________ , 20____
(This section to be used if required)
A
B
C
D
E
F
G
Date
Line
Rec’d
Method of Delivery
Purchased From
Point of Shipment
Sold To
Point of Delivery
Gallons
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36. Sub-total Gallons Imported . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Transfer sub-total on Line 36 to Line 8 on front side of this form).
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