The Texas 06 352 form, known as the End User Signed Statement for Purchasing Tax-Free Dyed Diesel Fuel, is a crucial document for entities purchasing dyed diesel fuel in Texas. This form ensures compliance with state regulations by confirming that the fuel will not be used on public highways or resold. Proper completion and retention of this form are essential for avoiding legal penalties associated with misuse of dyed diesel fuel.
The Texas 06 352 form, officially known as the End User Signed Statement for Purchasing Tax-Free Dyed Diesel Fuel, is an essential document for entities looking to purchase dyed diesel fuel without incurring tax liabilities. This form serves several critical functions, primarily aimed at ensuring compliance with state regulations regarding the use of dyed diesel fuel. It requires detailed information from the purchasing entity, including the name and address of the seller, as well as the purchaser's name and taxpayer number. The form also includes a series of declarations that the purchaser must affirm, such as the intended use of the fuel and whether it will be used in motor vehicles on public highways. Specific conditions apply; for example, if the purchaser intends to buy more than 10,000 gallons per month or plans to use the fuel in a motor vehicle, they may not be eligible to sign the statement. Moreover, exceptions exist for those involved in oil or gas production, who must provide additional documentation. This form is not just a procedural requirement; it carries legal implications, as false statements can lead to significant penalties. Keeping a master copy of the signed statement is crucial for record-keeping and compliance purposes.
06-352 (Rev.8-09/8)
TEXAS END USER SIGNED STATEMENT FOR PURCHASING TAX-FREE
DYED DIESEL FUEL
Selling supplier or distributor:
Address:
Purchasing entity name
End user signed statement number
Address
Beginning effective date
Taxpayer number
If the p urc has e r is a d iv is io n o f a c o rp o ratio n, g iv e the nam e and ad d re s s o f the p are nt c o rp o ratio n, no t the d iv is io n DBA nam e .
Parent corporation name:
PLEASE READ CAREFULLY BEFORE SIGNING
1.
Will you use any of this diesel fuel in a motor vehicle on public highways, streets or roads?
YES
2.
Will you resell any of this diesel fuel?
3.
Will you purchase more than 10,000 gallons per month?
NO NO NO
If any answer is "YES," you may not legally sign this statement.
EXCEPTION: A purchaser using an End User Signed Statement Number to purchase dyed diesel fuel for exclusive use in oil or gas production must
also furnish a Letter of Exception issued by the Comptroller to authorize the purchase of up to 25,000 gallons per month.
NOTE: THIS IS YOUR MASTER COPY. PLEASE RETAIN IN YOUR FILES AND MAKE COPIES AS NEEDED.
I DECLARE THAT:
none of the dyed diesel fuel purchased on this signed statement will be used on public highways, streets or roads;
all of the dyed diesel fuel purchased on this signed statement will be consumed by the purchaser in Texas and will not be resold; and
none of the dyed diesel fuel purchased on this signed statement will be delivered or permitted to be delivered into the fuel supply tanks of motor vehicles operating on public highways, streets or roads in this state.
I am aware that certain fines and criminal penalties are provided by law for giving a false diesel fuel signed statement.
Name of purchaser (Type or print)
By:
Purchaser or authorized representative (Type or print)
Signature of authorized representative
For information, call (800) 252-1383
or (512) 463-4600.
Date
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