Illinois Department of Revenue
MFT, UST, and EIF
Page ____ of ____
Schedule C
Sales and Transfers of Gasoline Products
Delivered to Points Outside of Illinois
Attach to Form RMFT-5 or Form RMFT-5-US
Step 1: Complete the following information
_______________________________________________
Company name
_______________________________________________
Your license number
________________________________________________
Name of state into which shipments were made
Reporting period __ __/__ __ __ __
Month
Year
Step 2: Report your exported gallons
1
2
3
4
5
6
7
8
Invoice date
Invoice
Name of
Bill of lading or
Origin
Destination
Invoiced
number
carrier
manifest number
Name of purchaser
(Illinois cities only)
(city and state)
gallons
(month, day, year)
1
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
2
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
3
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
4
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
5
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
6
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
7
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
8
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
9
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
10
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
11 Add the invoiced gallons in Column 8, Lines 1 through 10. Write the total amount here.
11
_________________
12 If you are filing only one Schedule C, write the amount form Line 11 here and on Forms RMFT-5 and RMFT-5-US, Line 7, Column 1.
12
_________________
If you are filing more than one Schedule C, add Line 11 from each schedule, and write the total on Line 12 of the last page.
Also write this amount on Forms RMFT-5 and RMFT-5-US, Line 7, Column 1.
This form is authorized as outlined by the Motor Fuel Tax Law and the Environmental Impact Fee Law. Disclosure of this information is REQUIRED.
Failure to provide information could result in a penalty. This form has been approved by the Forms Management Center.
IL-492-0083
RMFT-8 front (R-02/00)