Oil Spill Tax Return - Washington Department Of Revenue - April 2002
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1State of Washington
Department of Revenue
APRIL 2002
04
Taxpayer Account Administration
PO Box 47464
Olympia, WA 98504-7464
02
OIL SPILL TAX RETURN
ONLY Fill in Box if Amended/Supplemental Return Information is Attached
!
Address Changes?
business location
mailing address
both
Business closed?
Date closed ____/____/____
!
!
!
!
Please fill in the appropriate box and make address changes to above label.
Taxpayers With Direct Pay Certificates and Marine Terminal Operators
INSTRUCTIONS
Receiving for Themselves or for Others Report Here
Line
No. of Barrels
Tax Rate
Tax Due
No.
Marine Terminal Operators or Taxpayers With
Direct Pay Certificates
1
.04
Enter the total number of barrels of crude oil or
Credit for Export(s)
petroleum products first received in Washington
Line
Total No. of
Amount of Tax Claimed as Credit
Export Credit
from a waterborne vessel or barge on which you
No.
Barrels Exported
Where You Paid the Tax
are paying the tax this month. Multiply the barrels
2
received by the tax rate shown to get the amount
Line
Total No. of
Amount of Tax Claimed as Credit
Export Credit
No.
of tax.
Barrels Exported
Where a Previous Owner Paid the Tax
3
Credits for Export
If you exported crude oil or petroleum products on
Credit for Consumption or When Used as a Component to Manufacture a
which you or a previous owner has already paid
Non-Fuel Item
Line
this tax, enter the number of such barrels on line
No. of Barrels
Total Other Credit
No.
2 and/or line 3 as applicable. In the next column,
4
record the amount of the tax that had been
previously paid on these barrels.
MAY 2002
DUE DATE: MAY 25, 2002
Credits for Consumption or Manufacturing
S
M
T
W
T
F
S
25
!
5% Penalty is Due After May 28, 2002
1
2
3
4
Component
10% Penalty is Due After July 1, 2002
5
6
7
8
9
10
11
20% Penalty is Due After July 31, 2002
12
13
14
15
16
17
18
On line 4, enter the number of barrels of
If the due date falls on a weekend or legal holiday,
19
20
21
22
23
24
25
previously taxed oil or petroleum product on
the due date is extended to the next business day.
26
27
28
29
30
31
which you used as a consumer for a purpose
4 4 4 4
Please fill in this box if you had no business activity.
!
other than as a fuel, or you used as a component
4 4 4 4
For assistance, call (360) 902-7165.
or ingredient in the manufacture of an item which
4 4 4 4
Signature
is not a fuel. In the next column, record the
Ph. (
)
4 4 4 4
Date
amount of tax that had been previously paid on
Totals
those barrels.
Line
Description
Totals
No.
Credit Return
+
5
Tax Due (from line 1)
If the result of your tax due calculation is a credit,
–
6
Total Oil Spill Credits (add lines 2, 3 and 4)
we will send you a credit notice. Credit notices
=
may be used to offset future oil spill tax liabilities,
7
Total Tax (subtract line 6 from line 5)
or you may request a refund.
–
8
Credit Notices Applied (attach Credit Notice)
Payment
=
9
Tax Due (subtract line 8 from line 7)
MIMIMUM
Make your check or money order payable to the
+
10
Penalty*
$5.00
Washington State Department of Revenue and
+
11
Interest
mail to the Washington State Department of
=
12
Total Payment Enclosed** (add lines 9 through 11)
Revenue, PO Box 47464, Olympia WA 98504-
** Do not pay this tax with your Combined Excise Tax Return
7464.
For tax assistance, visit or call (800) 647-7706. To inquire about the availability of this document in an alternate format for the
visually impaired, please call (360) 486-2342. Teletype (TTY) users please call (800) 451-7985.
!
If you qualify, attach penalty waiver request and fill in box
REV 41 0066 APRIL/02 (3/29/02)
.
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