Form Mf-001w - Taxicab Claim For Fuel Tax Refund
Download a blank fillable Form Mf-001w - Taxicab Claim For Fuel Tax Refund in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Mf-001w - Taxicab Claim For Fuel Tax Refund with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4Instructions
Print
Clear
Taxicab Claim for Fuel Tax Refund
FILING REMINDER
FILE THIS CLAIM WITH:
Wisconsin Department of Revenue
Claims must be filed
Correct information printed below in BLACK ink.
Tab to navigate throughout form.
PO Box 8900
within one year from the
Madison WI 53708-8900
date fuel is purchased.
Legal Name
(608) 266-7363 or 266-6701
FEIN
Mailing Address - Street or PO Box Number
*X10107991*
SSNo
City
State
Zip
Wisconsin County of Business Location
Type of organization
(check one)
1.
Individual
3.
Wisconsin corporation
LLC - Taxed as partnership
2.
Partnership
4.
Out-of-state corporation
LLC - Taxed as corporation
5.
Other (
describe)
LLC - Single member LLC only
DATES OF FUEL PURCHASES COVERED BY THIS CLAIM
No refund will be issued
Date of FIRST purchase
(MMDDYYYY)
Date of LAST purchase
(MMDDYYYY)
on less than 100 gallons.
Period Covered by Your Invoices
Gas & Undyed Diesel Tax Rates
LPG Tax Rates
CNG Tax Rates
For periods after April 1, 2006
30.9¢ per gallon (.309)
22.6¢ per gallon (.226)
24.7¢ per gallon (.247)
REFUND COMPUTATION SCHEDULE
(Enter whole gallons only)
WISCONSIN FUEL PURCHASES BY TYPE OF FUEL
Gasoline
Undyed Diesel
LPG
CNG
1
Total gallons purchased and used by fuel type
1
2
Gallons on line 1 not used in a taxicab for transporting passengers
2
3
Gallons used on which refund is being claimed (line 1 less line 2
3
in each column). Enter total gallons on line 6
4
Fuel tax rates (enter one rate in each column from schedule above)
4
5
Compute refund (multiply gallons on line 3 in each column by the
5
fuel tax rate on line 4). Enter total refund on line 7/8
TOTAL GALLONS FROM LINE 3
TOTAL REFUND CLAIMED
6
7/8
$
Add all columns on line 3
Add all columns on line 5
TAXICAB SCHEDULE - See definition of Taxicab in the instructions
(attach additional sheets if necessary).
Beginning
Ending
Fleet
Vehicle
License
Passenger
Gallons of
Odometer Reading
Odometer Reading
Number
ID Number
Number
Capacity
Fuel Used
Date
Mileage
Date
Mileage
DECLARATION:
I declare that I have examined this claim and attachments and to the best of my knowledge and belief, it is true,
correct and complete. The fuel purchases on which this claim is based have been made within the last 12 months.
Signature
(do not print or type)
Business Telephone
Date
(
)
MF-001W (R. 6-07)
R610
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial