The Oklahoma 13 79 form serves as an Exemption Certificate, allowing certain entities to claim exemption from the Excise Tax under the Oklahoma Motor Fuel Tax Code. This form must be completed and retained by the vendor for a minimum of three years. It is essential for qualifying organizations, such as public school districts and volunteer fire departments, to accurately fill out this document to ensure compliance and avoid penalties.
The Oklahoma 13 79 form serves as a crucial document for individuals and entities seeking exemption from the excise tax imposed under the Oklahoma Motor Fuel Tax Code. This exemption certificate is specifically designed for various types of buyers, including public school districts, volunteer fire departments, and federally recognized Indian tribes, among others. Each entity must complete a separate certificate to validate their claim for tax exemption when purchasing specific fuel types, such as gasoline, undyed diesel, compressed natural gas (CNG), and liquefied natural gas (LNG). The form requires the vendor's information, including name, address, and Federal Employer Identification Number (FEIN), ensuring proper documentation is retained for a minimum of three years. Additionally, the buyer must provide their details, including a signature, to affirm the accuracy of the information and acknowledge the potential consequences of fraudulent use. The form emphasizes the importance of completeness, as any omissions may lead to the disallowance of the exemption. Understanding the stipulations of this form is essential for eligible entities to benefit from the tax relief it offers.
FORM 13-79
REVISED 11-2013
EXEMPTION CERTIFICATE
To support Buyer’s claim for an exemption from payment of Excise Tax levied under the Oklahoma Motor Fuel Tax Code.
(Vendor shall retain this document for not less than three (3) years)
______________________________________________
_______________________________________________
Name of Vendor
Vendor FEIN
_________________________________________________________________________________________________
Address of Vendor
_____________________________________________________
______________
__________________________
City
State
Zip Code
To be submitted to the following Supplier, CNG and/or LNG Wholesaler/Retailer:
Name: ________________________________________
FEIN: __________________________________________
THIS EXEMPTION APPLIES TO: (CHECK ONLY ONE TYPE OF ENTITY)
COMPLETE A SEPARATE EXEMPTION CERTIFICATE FOR EACH EXEMPT ENTITY.
Public School District, FFA, 4-H Club for the Purpose of Transporting Public School Children
School District for Operation of Vehicles Used in Driver Training
Volunteer Fire Department
Rural Electric Cooperative
Rural Water and Sewer District
Rural Amublance Service District
Federally Recognized Indian Tribe
Agency or Instrumentality of the United States
City, County, or Town
State of Oklahoma, Underground Storage Fee
FOR PURCHASE OF: (CHECK WHICH FUEL TYPE(S) APPLY)
Gasoline
Undyed Diesel
(Number of Gallons: _____________________ )
CNG
Petroleum Underground
Storage (Number of Gallons: ______________ )
LNG
Period in which the fuel was purchased: _______________________________________________________________
The BUYER understands that the fraudulent use of this certiicate to obtain fuel without paying the tax levied will result in BUYER paying the tax, with penalties and interest.
Name of Buyer
Social Security Number or FEIN
_____________________________________________________________________ ( ______ ) _________________
Address of BuyerTelephone Number of Buyer
_____________________________________________________ ______________
Signature of Buyer
Date Signed
Printed or Typed Name of Person Signing
Title of Person Signing
OMITTING Information required by Section 500.13 may result in the DISALLOWANCE of the Exemption.
Except for the ORIGINAL SIGNATURE, this form may be duplicated for future purchases.
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