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WDepartment of Taxation and Finance New York State and Local Sales and Use Tax The following information should be submitted by registered mail at least 10 days before taking possession of or paying for the Purchaser or representative™s name Seller or representative™s name Escrow agentNumber and street Number and street Number and street Telephone number with area code Telephone number with area code Telephone number with area code( ) ( ) ( ) Purchaser™s Purchaser™s name Seller™s name Business or trade name Business or trade nameBusiness location Business location a) Scheduled date of sale b) Location of property when transferred c) Type of business or property sold d) Amount of escrow fund e) Name of bank in which escrow fund is deposited Address Bank telephone number ( ) g) Terms and conditions of sale f) Sales prices of assets sold: tools and supplies Total sales price statements with the knowledge that willfully issuing a false or fraudulent document with the intent to evade tax may constitute a felony under New York State Date Signature Title conditions thereof whether or not the seller, transferor or assignor, has represented to, or informed the purchaser, transferee or assignee that he owes any tax pursuant to this article, and whether or not the purchaser, transferee, or assignee has knowledge that such taxes are owing, and whether any such taxes are in
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