Form Tc-920 - Ifta License And Special Fuel User (Sfu) Permit Application
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1
2IFTA
Utah State Tax Commission
IFTA License and Special Fuel
TC-920
Rev. 12/97
User (SFU) Permit Application
application is on the reverse side of this form.
SPECIAL FUEL USER
Requirements to determine if you need to apply for an IFTA License
1. Do you have Utah registered gas, propane, natural gas, or diesel
You may not apply for an IFTA license if you answered “ N o”on either
powered vehicles that operate outside of Utah (Interstate)?
question 1 or 2.
2. Do these Utah registered gas, propane, natural gas, or diesel
ADDITIONALLY:
powered vehicles have a gross vehicle weight or registered gross
If you have bulk storage of diesel in Utah and have two
vehicle weight over 26,000 pounds or do they have three axles?
axle diesel vehicles registered under 26,001 pounds, you are required to
apply for a Special Fuel User Permit. Complete the SFU form on the reverse
If you answered “ Y es”to both questions 1 and 2 question above, then you
side.
are required to apply for a IFTA License. Complete Sections 1 & 2.
Section 1 - General Information
2. Type of Ownership:
1. Business Name and Address (P.O. Box Not Acceptable):
Individual SSN: _______ - ______ - _________
Partnership Fed ID: _____ - _______________
Corporation Fed ID: _____ - _______________
IRP #: _____________________
A pplication will not be accepted
without the Utah IRP number. Normally, all IFTA license holders will
have an IRP account. If not, please attach an explanation.
U.S. DOT #: _____________________
3. Mailing Address if Different Than Business Address:
Fax telephone number
4. Telephone Number
5. Identify Owner, Partners or Corporate Officers:
Name, Address, City, State, ZIP Code
Telephone
Social Security Number
OP = Operations
BF = Bulk Fuel
Section 2 - IFTA Section
OP
OP
BF
BF
OP
BF
OP
BF
AL - Alabama
KY - Kentucky
NC - North Carolina
WI - Wisconsin
AK - Alaska
LA - Louisiana
ND - North Dakota
WY - Wyoming
AZ - Arizona
ME - Maine
OH - Ohio
AB - Alberta
AR - Arkansas
MD - Maryland
OK - Oklahoma
BC - British Columbia
CA - California
MA - Massachusetts
OR - Oregon
MB - Manitoba
CO - Colorado
MI - Michigan
PA - Pennsylvania
NB - New Brunswick
CT - Connecticut
MN - Minnesota
RI - Rhode Island
NF - New Foundland
DE - Delaware
MS - Mississippi
SC - South Carolina
NS - Nova Scotia
DC - Dist. of Col.
MO - Missouri
SD - South Dakota
NT - N W Territories
FL - Florida
MT - Montana
TN - Tennessee
ON - Ontario
GA - Georgia
NE - Nebraska
TX - Texas
PE - Prince Edwards Is.
ID - Idaho
NV - Nevada
UT - Utah
PQ - Quebec
IL
- Illinois
NH - New Hampshire
VT - Vermont
SK - Saskatchewan
IN - Indiana
NJ - New Jersey
VA - Virginia
YT - Yukon Territory
IA
- Iowa
NM - New Mexico
WA - Washington
MX - Mexico
KS - Kansas
NY - New York
WV - West Virginia
Applicant agrees to comply with reporting, payment, record keeping, and license display
1. Number of decals needed
requirements as specified in the International Fuel Tax Agreement. The applicant further
$4.00
agrees that the base jurisdiction may withhold refunds due if applicant is delinquent on
2. Decal cost
payment of fuel taxes due any member jurisdiction. Failure to comply with these
Amount due
$
requirements shall be grounds for revocation of license in all member jurisdictions.
(multiply line 1 by line 2)
Signature
Date signed
Title
X
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