New Jersey Claim for Refund of Estimated Gross Income Tax Payment.

Claim for Refund of Estimated Gross Income Tax Payment.
Claim For Refund of The Estimated Gross Income Tax Payment for The Sale of New Jersey Real Estate, Form A-3128
A-3128
	

New Jersey
Division of Taxation

(5-21)

Claim for Refund of the
Estimated Gross Income Tax Payment
for the Sale of New Jersey Real Estate

For Official Use Only
Claim No.

To qualify for this refund, taxpayers must:
1)	 Attach a copy of the GIT/REP-3 form if they erroneously paid estimated tax and qualify for one of the exemptions listed on the
GIT/REP-3; or
2) 	Attach documentation that they overpaid estimated tax based on calculated gain on sale of property.

Print or Type This Form.

Social Security Number(s)

Name of Taxpayer(s):	

Last	

Current Address of Taxpayer(s):	

First	

Number and Street

City	

Address of Property Sold:	

State	

ZIP Code

State	

ZIP Code

Number and Street

City	

Property Use:	

Middle

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, Seller’s Residency Certification/
Exemption, enter $0. A completed copy of the GIT/REP-3 Form indicating your exemption status must be attached.
Tax Rate Table
Date Sold:
Date Purchased:
Percentage Owned:

	

	

Sale Price:	

$

	 Federal Adjusted Basis:	 $
	 Net Gain/Loss:	

(If Net Loss - enter $0.)

Estimated Gross Income Tax Payment submitted:	

$

$

Applicable Tax Year:
** Estimated Tax Liability Due:		

Amount of Refund Claim:		

$

Net Gain
Over

But Not
Over

Multiply

Net Gain

By

$0

$20,000

x

0.014

$20,000

$35,000

x

0.0175

$35,000

$40,000

x

0.035

$40,000

$75,000

x

0.05525

$75,000

$500,000

x

0.0637

$500,000

$1,000,000

x

0.0897

$1,000,000

and over

x

0.1075

Estimated
Tax Liability

$

Additional Information may be requested in order to complete your claim for a refund. The Division must have a record of receiving
the “Estimated Gross Income Tax Payment submitted” before your claim can be processed.
**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.

Appointment of Taxpayer Representative
If this form is being prepared by anyone other than the taxpayer(s), an Appointment of Taxpayer Representative 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 along with the Settlement Statement (HUD-1) or Closing Disclosure form to:
Division of Taxation
Taxpayer Accounting Branch
P.O. Box 046
Trenton, N.J. 08646-0046

Instructions for Form A-3128
Note: Use this form to claim a refund. Do not use form GIT/REP-4 to claim a refund.
	 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 N.J.S.A. 54A:8-8 through N.J.S.A. 54A:8-10. This form can only be filed with the Division of
Taxation after the recording of the deed with the county clerk.
	 2.	 Separate forms must be used for each taxpayer, except for husband and wife who 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, percentage owned, and net gain/loss of the property
sold.
	 7.	 Calculate and enter the estimated tax liability using the table provided on the form. 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 indicating your exemption status must be attached.
Example:
Tax Rate Table
Date Sold: 2/4/20	

Sale Price:

$315,000

Date Purchased: 9/21/16	

Federal Adjusted Basis:

$279,000

Percentage Owned: 100%	

Net Gain/Loss:
(If Net Loss, enter $0.)

$36,000

	

Estimated Gross Income Tax Payment submitted:

$6,000

** Estimated Tax Liability Due:

$1,260

Amount of Refund Claim:

$4,740

Net Gain
Over

But Not
Over

Multiply

Net Gain

By

$0

$20,000

x

0.014

$20,000

$35,000

x

0.0175

$35,000

$40,000

x

$40,000

$75,000

x

0.05525

$75,000

$500,000

x

0.0637

$500,000

$1,000,000

x

0.0897

$1,000,000

and over

x

0.1075

$36,000

0.035

Estimated
Tax Liability

$1,260

	 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 the net refund being claimed.
	 10.	 Whenever an agent on behalf of the taxpayer executes a claim, an Appointment of Taxpayer Representative specifically authorizing
such agent to act on behalf of the taxpayer must accompany the claim for refund form.
	 11.	 Mail this claim for refund along with the Settlement Statement (HUD-1) or Closing Disclosure form to:
New Jersey Division of Taxation
Taxpayer Accounting Branch
PO Box 046
Trenton, NJ 08646-0046
	 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 Division of Taxation receives a properly
completed claim form along with the required documentation.