Indiana > Statewide > Department Of Revenue > Fuel And Environmental > Special Fuel
Amended Terminal Operators Monthly Return FT-501X - Indiana
| Amended Terminal Operators Monthly Return Form. This is a Indiana form and can be used in Special Fuel Fuel And Environmental Department Of Revenue Statewide . |
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INDIANA DEPARTMENT OF REVENUE FT-501X State Form 47736 (4-03) Amended Terminal Operator's Monthly Return Due date is the 20th of the following month. For the month of:_________________, 20_____ A Terminal Operator's Report Must Be Filed for Each Indiana Location Being Amended Name of License Holder (as indicated on license) License Number Mailing Address Federal 637 License Number FEIN/SSN City or Town State Zip Code Business Telephone Number Terminal Information Name of Terminal Terminal Code Location Net Gallons as Previously Reported Column A Column B Special Fuel Gasoline (Dyed and (Gasoline, Clear Gasohol) Diesel Fuel) Net Gallons As Amended Column B Gasoline (Gasoline, Gasohol) Column C Other Products (Jet Fuel, Kerosene) Monthly Transactions For Owned/Leased Terminal Space 1. Beginning Physical Inventory From Schedule Column C Column A Special Fuel Other (Dyed and Products (Jet Fuel, Clear Diesel Fuel) Kerosene) 2. Total Receipts 501A 3. Total Disbursements 501B 4. Stock Gains & Losses + - 5. Ending Physical Inventory (Line 1 plus Line 2 minus Line 3 plus/minus Line 4) Mail Return To: Indiana Department of Revenue P.O. Box 6080 Indianapolis, IN 46206-6080 I do hereby certify under penalty of perjury that, for the terminal location indicated above, the foregoing and attached schedules and reports are a true and correct statement to the best of my knowledge and is a complete and full presentation of all transactions from the best information available. Taxpayer or Authorized Agent Typed or Printed Name Date Signed Please Check Box If Last Filing American LegalNet, Inc. www.FormsWorkflow.com Title Telephone Number Instructions for Completing Amended Terminal Operator's Monthly Return (FT-501X) Who Should File This Return? You should file this form if you are an Indiana Licensed Special Fuel Terminal Operator and you need to amend or change a previously filed Terminal Operator's Monthly Tax Return, Form FT-501. How Do I Complete the FT-501X? You should refer to the instructions for your original Terminal Operator's Monthly Tax Return, and related schedules, for the tax period being amended. Enter your company's identifying information on form FT-501X and all accompanying schedules. Complete all information, leaving nothing blank. It is critical that you use the same license number on this report that is shown on your actual license. A separate FT-501X must be filed for each tax period requiring an amendment. Net Gallons as Previously Reported: Complete lines 1 through 5 of Column A, Column B and Column C by entering the amounts as reported on your original tax return, or as previously amended. (If previously amended, lines 1 through 5 will be the amounts reported in column titled "Net Gallons as Amended" of the previously filed amended return.) Net Gallons as Amended: Use this column to report changes in line amounts from those previously reported. Changes in column titled "Net Gallons as Amended" must be documented by attaching the corresponding schedules, as amended. If there is no change to a particular line entry, enter zero. To Obtain Forms Visit our web site on the Internet and download the forms you need. Our address is: www.in.gov/dor/. Or you may obtain additional forms and schedules by fax 24 hours a day by calling (317) 233-2329 from the telephone portion of your fax machine. What if I Have Other Questions? If you have other questions, contact our office by calling 317-615-2630, or by writing to: Indiana Department of Revenue P. O. Box 6080 Indianapolis, IN 46206-6080 American LegalNet, Inc. www.FormsWorkflow.com
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