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Claim For Refund Of Estimated Gross Income Tax Payment A-3128 - New Jersey
| Claim For Refund Of Estimated Gross Income Tax Payment Form. This is a New Jersey form and can be used in Gross Income Tax Returns Division Of Taxation Statewide . |
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A-3128 State of New Jersey Division of Taxation CLAIM FOR REFUND OF ESTIMATED GROSS INCOME TAX PAYMENT PAID UNDER PROVISIONS OF C. 55, P.L. 2004 In order to qualify for this refund -1) Taxpayer(s) erroneously paid estimated tax and qualify for one of the exemptions listed on the GIT/REP-3 Form. 2) Taxpayer(s) overpaid estimated tax based on calculated gain on sale of property. PLEASE PRINT OR TYPE THIS FORM. Social Security No(s): Name of Taxpayer(s): Current Address of Taxpayer(s): City: Last Number and Street State: Zip Code: First For Official Use Only Claim No. Middle Address of Property Sold: City: Number and Street State: Zip Code: Property Use: ________ Personal/Vacation ________ Rental ________ Business ** Use the Schedule below to determine your estimated tax liability. ** Taxpayers who submitted an erroneous payment and qualify for an exemption on the GIT/REP-3 Form-Seller's Residency Certification/Exemption - enter $0 A completed copy of the GIT/REP-3 Form indicating your exemption status must be attached. Date Sold: ____________ Sale Price: Federal Adjusted Basis: $ ________________ Net Gain Date Purchased: ____________ $ ________________ Over $0 Net Gain/Loss: $ ________________ (If Net Loss - enter $0.) Estimated Gross Income Tax Payment submitted: Applicable Tax Year: ____________ $ ________________ ** Estimated Tax Liability Due: $ ________________ $20,000 $35,000 $40,000 $75,000 $500,000 But Not Over $20,000 $35,000 $40,000 $75,000 $500,000 and over Multiply x x x x x x Net Gain __________ __________ __________ __________ __________ __________ by: 0.015 0.025 0.035 0.055 0.065 0.085 Tax Rate Table Estimated Tax Liability __________ __________ __________ __________ __________ __________ Amount of Refund Claim: $ ________________ Additional Information may be requested in order to complete your claim for a refund. ** Payment of the Etimated Tax Liability does not relieve you of your responsibility to file the required return, nor does it close the tax year covered. The tax year remains open until the required return has been filed and accepted, all tax, penalties, and interest charges have been paid, and the statutory audit period has expired. Power of Attorney: If this Claim Form is being prepared by anyone other than the taxpayer(s), a Power of Attorney must be included Under penalties of perjury, I declare that I have examined this claim, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer is based on all information of which preparer has any knowledge. Signature of Claimant(s)/Preparer: _________________________________________ _________________________________________ Date: ________________ If the preparer of this claim has been paid, indicate the firm's name, address, the firm's Federal EIN and the preparer's Social Security Number, Federal Identification Number or Federal Preparer Tax Identification Number. Firm's Name: Preparer's SS # or Federal PTIN: Firm's Address: Preparer's Federal EIN: Mail this claim form to: Division of Taxation Taxpayer Accounting Branch PO Box 266 Trenton, NJ 08695-0266 American LegalNet, Inc. www.FormsWorkflow.com Instructions for Form A-3128 1. This form is to be completed by nonresident individuals, estates or trusts to claim a refund of estimated gross income tax payment paid under provisions of C. 55, P.L. 2004. 2. Separate forms must be used for each taxpayer, except for Husband & Wife that file jointly. 3. Include taxpayer's current address or address where refund should be mailed. 4. Include the address of property sold and the amount of refund being requested. 5. Check box indicating type of property use. 6. Include the Date of Sale, Sale Price, Date of Purchase, Federal Adjusted Basis, and Net Gain/Loss of the property sold. 7. Calculate and enter your estimated tax liability using the Table provided on the form. Example: ** Use the Schedule below to determine your estimated tax liability. ** Taxpayers who submitted an erroneous payment and qualify for an exemption on the GIT/REP-3 Form Seller's Residency Certification/Exemption - enter $0. A completed copy of the GIT/REP-3 Form indicating your exemption status must be attached. Date Sold: 02/04/2005 Sale Price: Federal Adjusted Basis: Net Gain/Loss: (If Net Loss - enter $0.) Estimated Gross Income Tax Payment submitted: ** Estimated Tax Liability Due: Amount of Refund Claim: $300,000 Net Gain Date Purchased: 09/21/2001 $279,000 $21,000 $6,000 $525 $5,475 Over $0 $20,000 $35,000 $40,000 $75,000 $500,000 But Not Over $20,000 $35,000 $40,000 $75,000 $500,000 and over Multiply x x x x x x Net Gain __________ $21,000 __________ __________ __________ __________ by: 0.015 0.025 0.035 0.055 0.065 0.085 Tax Rate Table Estimated Tax Liability __________ $525 __________ __________ __________ __________ 8. Include the estimated Gross Income Tax payment submitted. ** Payment of the Estimated Tax Liability does not relieve you of your responsibility to file the required return nor does it close the tax year covered. The tax year remains open until the required return has been filed and accepted, all tax, penalties, and interest charges have been paid, and the statutory audit period has expired. 9. Enter the amount of your Net Refund being claimed. 10. Whenever an agent on behalf of the taxpayer executes a claim, a Power of Attorney specifically authorizing such agent to act on behalf of the taxpayer must accompany the claim for refund form. 11. Mail this claim for refund to: New Jersey Division of Taxation Taxpayer Accounting Branch PO Box 266 Trenton, NJ 08695-0266 12. Failure to complete all required lines on Form A-3128 or to attach required documentation will result in the claim being rejected as incomplete. Incomplete claims will be returned. Claims will not be deemed filed until the Divison of Taxation receives a properly completed claim form. American LegalNet, Inc. www.FormsWorkflow.com
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