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Consolidated Gasoline Monthly Tax Return MF-360 - Indiana

Consolidated Gasoline Monthly Tax Return Form. This is a Indiana form and can be used in Gasoline Fuel And Environmental Department Of Revenue Statewide .
 Fillable pdf Last Modified 11/16/2009
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MF-360 State Form 49276 (R3/6-05) Name of License Holder (as indicated on license) Mailing Address City or Town State Indiana Department of Revenue Consolidated Gasoline Monthly Tax Return Due date is the 20th of the following month. For the month of:_________________ 20_____ License Number (as indicated on license) FEIN/SSN Zip Code Business Telephone Number Contact Name This is a consolidated return for all license types listed below. Place an "X" in the box to the left of each license type for which you are licensed. Section 1: Filing Types Gasoline Oil Inspection Distributor 1. 2. 3. 4. 5. 6. 7. Gasohol Blender Section 2: Calculation of Gasoline Taxes Due 1. Total receipts (From Section A, Line 7, Column D on back of return) 2. Total non-taxable disbursements (From Section B, Line 9, Column D on back of return) 3. Gallons received, gasoline tax paid (From Section A, Line 1, Column A on back of return) 4. Billed taxable gallons (Line 1 minus Line 2 minus Line 3) 5. Licensed gasoline distributor deduction (Multiply Line 4 by 0.016) 6. Billed taxable gallons (Line 4 minus Line 5) 7. Gasoline tax due (Multiply Line 6 by $0.18) 8. Adjustments ( Schedule E-1 must be attached and is subject to Department approval) 9. Total gasoline tax due (Line 7 plus or minus Line 8) + 8. 9. 1. 2. 3. 4. 5. Section 3: Calculation of Oil Inspection Fees Due 1. Total receipts (From Section A, Line 8, Column D on back of return) 2. Total non-taxable disbursements (From Section B, Line 10, Column D on back of return) 3. Gallons received, oil inspection fee paid (From Section A, Line 1, Columns D on back of return) 4. Billed taxable gallons (Line 1 minus Line 2 minus Line 3) 5. Oil inspection fees due (Multiply Line 4 by $0.01) 6. Adjustments (Schedule E-1 must be attached and is subject to Department approval) 7. Total oil inspection fees due (Line 5 plus or minus Line 6) + 6. 7. 1. 2. 3. 4. 5. Section 4: Calculation of Total Amount Due 1. 2. 3. 4. 5. 6. Total amount due (Section 2, Line 9 plus Section 3, Line 7) Penalty Interest (Penalty must be added if report is filed after the due date. 10% of tax due or $5.00, whichever is greater. Five dollars ($5.00) is due on a late report showing no tax due.) (Interest must be added if report is filed after the due date. Contact the Department for daily interest rates.) Net tax due (Line 1 plus Line 2 plus Line 3) Payment(s) Balance due (Line 4 minus Line 5) For Department Use Only Check Check Amount: Number: 7. 6. 7. Gallons of gasoline sold to taxable marina Make checks payable to Indiana Department of Revenue and mail to: P.O. Box 510, Indianapolis, Indiana 46206-0510. Include your License Number on check. Under penalty of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is true, correct, and complete. Taxpayer or Authorized Agent Type or Print Name Date Signed Title Telephone Number ( ) Please Check Box If Last Filing Date Business Closed / / American LegalNet, Inc. www.FormsWorkflow.com Section A: Receipts D From Schedule Gasoline/ Aviation Gasoline/Gasohol A K-1/K-2 Kerosene B All Other Products C Totals 1. 2 2K 2X 3 4 Gallons received, gasoline tax or inspection fee paid 1A 2. Gallons received from licensed distributors or oil inspection distributors, tax unpaid 3. Gallons of non-taxable fuel received and sold or used for a taxable purpose 4. Gallons received from licensed distributors on exchange agreements, tax unpaid 5. Gallons imported directly to customer 6. Gallons imported into own storage 7. Total receipts - add Lines 1-6, carry total (Column D) to Section 2,Line 1 on front 8. Total Receipts - add Lines 1-6, carry total (Column D) to Section 3, Line 1 on front From Schedule Gasoline/ Aviation Gasoline/Gasohol A K-1/K-2 Kerosene B Totals D All Other Products C Section B: Disbursements 5 6D 6X 7 8 10A 10B E-1 E-1 1. Gallons delivered, tax collected 2. Gallons sold to licensed distributors, tax not collected 3. Gallons disbursed on exchange 4. Gallons exported (must be filed in duplicate) 5. Gallons delivered to U.S. Government - tax exempt 6. Gallons delivered to licensed marina fuel dealers 7. Gallons delivered to licensed aviation fuel dealers 8. Miscellaneous deduction - theft/loss 8a. Miscellaneous deduction - off road, other 9. Total non-taxable disbursements - add Lines 2-8a, carry total to Section 2 line 2 on front. American LegalNet, Inc. www.FormsWorkflow.com 10. Total non-taxable disbursements - add Lines 2-5, carry total to Section 3 line 2 on front Instructions for Completing Consolidated Gasoline Monthly Tax Return (MF-360) Who should file this return? A gasoline tax is imposed on every gallon of gasoline received in Indiana less those deductions provided by law. The gasoline tax rate is eighteen cents ($0.18) per gallon. Each person who holds a valid Indiana Gasoline Distributor's License must file Form MF-360, Consolidated Gasoline Monthly Tax Return and schedules with the Indiana Department of Revenue. Distributors are required to indicate on such returns all gasoline received as well as support all deductions claimed, during the month for which the return is filed. A return must be filed each month, even if the distributor has no activity to report on the return. Section 1 Place an "X" in the box for each license type for which your return is being filed. Example: If you are a licensed Gasoline Distributor you will place an "X" in that box. Section 2 Calculation of Gasoline Taxes Due Line 1: Enter the total amount of gasoline purchased, acquired or imported during the month from Section A, Line 7 Column D on back of return. Line 2: Enter the total of non-taxable disbursements made during the month from Section B, Line 9, Column D on back of return. Line 3: Enter the total gallons of gasoline received, gasoline tax paid From Section A, Line 1, Column A on back of return. Line 4: Enter the total billed taxable gallons (Line 1 minus Line 2 minus Line 3). Line 5: Licensed Gasoline Distributors who file their returns timely and remit all amounts of tax due timely are entitled to claim a gallonage allowance of one and six-tenths percent (1.6%) of the gallons of gasoline received, less deductions. The deduction will not be allowed if a monthly return and schedules and/or tax remittance is filed after the due date of the return. When is the return/payment due? Form MF-360 and schedules must be filed on or before the twentieth (20th) day
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