Follow the steps to complete the 911 Verification Form online

1. Click ‘Get Form’ button to obtain the 911 Verification Form and open it in the online editor.
2. Begin by filling in the name of the distributor and the federal employer identification number (EIN) in the designated fields.
3. Indicate the month/year or quarterly period for which you are reporting.
4. In Part 1, report receipts of non-highway diesel motor fuel from out-of-state suppliers by entering the following details: date (you can aggregate various receipts on one line), supplier’s name and address, supplier’s EIN, product code, and total gallons imported.
5. Proceed to Part 2, where you will list receipts from in-state suppliers. Similar to Part 1, provide the date, supplier’s name, EIN, product code, and total gallons for purchases made in New York State.
6. In Part 3, document sales to exempt organizations. Enter the date, the exempt organization’s name and address, their exemption number, and the number of gallons sold.
7. For Part 4, report sales of non-highway diesel motor fuel to manufacturers. Enter the date, purchaser’s name and address, purchaser’s EIN, and the number of gallons sold.
8. In Part 5, list sales to governmental entities. Enter the date, name of the governmental entity, contract or approval number, and the number of gallons sold.
9. Continue to Part 6 for sales of railroad diesel. Input the date, purchaser’s name and address, purchaser’s EIN, and gallons sold.
10. Finally, in Part 7, outline sales or use for farming. Enter the date, purchaser’s name and address, their EIN, and differentiate between gallons used directly in production and other gallons.
11. Review all provided information for accuracy. Once completed, save changes, download, print, or share the form as necessary.

Complete your 911 Verification Form online today for timely processing.