N.Y. Comp. Codes R. & Regs. tit. 20, § 561.5
(a) Upon each sale of motor fuel, other than transfers made prior to or during the importation of such fuel into this State and retail sales made in the State, the seller is required to give to the purchaser at the time of delivery of the motor fuel a certification:
(2) Where the seller is other than the registered distributor responsible for payment of such taxes, such seller shall certify that it is passing through both the motor fuel tax required to be paid under article 12-A of the Tax Law and the prepaid tax required to be paid by section 1102 of the Tax Law which taxes were both previously paid or assumed by a registered distributor and passed through to such seller.
Such certification shall be on the form prescribed by the Department of Taxation and Finance for such purpose or incorporated, as prescribed by the Department of Taxation and Finance, into an invoice or other billing or shipping document. Also see section 561.6 of this Part with respect to preliminary certifications of tax payment.
(c) Except with respect to a transfer of motor fuel made prior to or during the importation of the motor fuel into the State, if a properly completed certification is furnished to a purchaser by his seller and if such certification is accepted in good faith, the purchaser is relieved of any liability for the taxes on such motor fuel. In such event, the seller shall bear the burden of showing that the motor fuel and prepaid sales taxes have been paid or passed through with respect to such motor fuel.
(8) the name of the person who paid the motor fuel tax and prepaid sales tax or assumed liability for the payment of such taxes and that person's sales tax registration and motor fuel tax registration number; and
(ii) if the seller is other than the registered distributor responsible for payment of the motor fuel tax and the prepaid sales tax, a signed statement to the effect that it is passing through such taxes which were previously paid or assumed by a registered distributor and which were passed through to it.
Where the certification is contained on an invoice or other billing or shipping document, no signature is required if the seller is a registered motor fuel distributor under article 12-A of the Tax Law. In all other cases, said certification must be signed.
(9)
(d) Contents of the certification.
A certification of tax payment is considered to be properly completed when it contains: