Au 11 Tax Form – Fill Out and Use This PDF

Under Applicant information (Please type or print legibly), enter the Name (Legal business name, including DBA or individual), Telephone number, and NYS Sales Tax ID number (if registered) or EIN or social security number.

Enter the Mailing address (number and street or rural route).

Enter the City, State and ZIP code.

Enter the Period covered by claim (date(s) of purchase) as mm/dd/yyyy.

Enter the Refund claimed $.

If you claim credit, enter the Credit claimed $.

If credit shown in Credit claimed has already been claimed on a sales tax return, enter the period covered by the quarterly or annual return (mm/dd/yyyy).

Enter the Representative's name (if any); see instructions, and the Telephone number.

Enter the Representative's mailing address (number and street or rural route), City, State and ZIP code.

Enter the Explanation of your claim:

Under Certification: I, enter your name as the applicant named in Applicant information, or partner, or other authorized representative of such applicant, who does hereby make application for credit and/or refund of tax, pursuant to the New York State Tax Law.

You certify that the statements, and any documents provided to substantiate the credit or refund claimed, are true, complete and correct and that no material information has been omitted.

You certify that all of the tax has been paid, and no portion has been previously credited or refunded to the applicant by any person required to collect tax; or, if the claim for credit or refund is made by a person required to collect tax, that the amount claimed has previously been refunded to the appropriate purchaser.

You certify that no amount claimed has previously been subject to a credit or refund.

You understand that the Tax Department is authorized to investigate the validity of the credit or refund claimed and the accuracy of any information provided with this claim.

Sign at Applicant's signature and enter Applicant's title and Date.

Sign at Representative's signature (if any) and enter Representative's ID number and Date.

The New York State Department of Taxation and Finance Application for Credit or Refund of Sales or Use Tax. Read Form AU-11-I, Instructions for Form AU-11, before completing this application.

If you're a business, you may submit Form AU-11, Application for Credit or Refund of Sales or Use Tax, online. It's fast, easy, and free.⁠^[2]

You make these statements with the knowledge that willfully providing false or fraudulent information with this document with the intent to evade tax may constitute a felony or other crime under New York State Law, with a possible jail sentence.

Do not use this form to apply for a Qualified Empire Zone Enterprise (QEZE) refund or credit for purchases made on or after September 1, 2009. Use Form AU-12, Application for Credit or Refund of Sales or Use Tax - Qualified Empire Zone Enterprise (QEZE). Do not use this form to apply for a refund of tax paid on qualifying purchases of motor fuel or diesel motor fuel. Use Form FT-500, Application for Refund of Sales Tax Paid on Automotive Fuels.