Form Ref-1000 - Claim For Fuel Tax Refund - Indiana Department Of Revenue Page 3
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5Bookmobile
25%
Milk Tank Truck
30%
Service Truck with Pneumatic Drill
15%
Sewer Cleaning Truck/Sewer Jet/Sewer
Boom Truck/Block Boom
20%
Mobile Crane
42%
Vactor
35%
Bulk Feed Truck
15%
Pneumatic Tank Truck
15%
Snow Plow Truck
10%
Car Carrier with Hydraulic Winch
10%
Ready Mix Concrete Truck
30%
Spray Truck
15%
Carpet Cleaning Van
15%
Refrigeration Truck
15%
Super Sucker Truck
90%
Salt Spreader/Dump Truck
Digger-Derrick Truck
20%
with Spreader
15%
Sweeper Truck
20%
Dump Truck
23%
Sanitation Dump Trailer
15%
Tank Transport
15%
Fire Truck
48%
Sanitation Truck
41%
Tank Truck
24%
Hot Asphalt Distribution Truck
10%
Seeder Truck
15%
Truck with Power Take-Off Hydraulic Winch
20%
Semi-Tractor and Dump
Leaf Truck
20%
Trailer Combo
15%
Wrecker
10%
Lime Spreader Truck
15%
Semi Wrecker
35%
Service Truck with Jack
Line Truck/Aerial Lift Truck
20%
Hammer
15%
This claim must be signed by the taxpayer or by an authorized agent. If signed by an authorized agent, a properly completed power of
attorney form must be attached.
I hereby certify that the amount claimed is legally due, after allowing all just credits, and that no part of the same has been paid. I further
understand that this refund may be applied to any liability which I currently have outstanding. Under penalties of perjury, I declare that I
have examined this form and to the best of my knowledge and belief it is true, correct, and complete.
_________________________________
_________________________________
_________________
Printed Name
Signature
Date
Mailing/Contact Information:
For Department Use Only:
Indiana Department of Revenue
________________________________
________________
Special Tax Division
Auditor/Tax Analyst
Date
P.O. Box 1971
Indianapolis, IN 46206-1971
________________________________
________________
(317) 615-2630
Supervisor
Date
fetax@dor.in.gov
________________________________
________________
Approving Authority
Date
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Parent category: Financial