Form Rmft-11-A - Illinois Motor Fuel Tax Refund Claim For Tax Paid On Or After January 1, 2001 Page 2
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4Step 6: Describe the gasoline you used for nonhighway purposes
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22
Acres under cultivation
Number of livestock maintained
Beans
________________
Beef cattle
________________
Corn
________________
Dairy cattle
________________
Hay
________________
Poultry
________________
Small grain
________________
Sheep
________________
Swine
________________
13
Acres of custom work
_______________
(production and operation)
23
Other farm operations that are included
14
Number of gallons pumped
in your refund claim
Acres of
Gasoline
________________
Fuel oil
________________
Bluegrass planting
________________
LPG from a 300 - 500
Bushhogging
________________
gallon tank
________________
Chisel plowing
________________
LPG from tanks larger
Chopping stalks
________________
than 500 gallons
________________
Combining
________________
Cultivating
________________
15
Number of gallons used to
Discing
________________
Clear timber
________________
Insecticide sprayed
________________
Mix cement (PTO)
________________
Moldboard plowing
________________
Mix cement (non-PTO)
________________
Mowing
________________
Operate irrigation equipment
________________
Nurseries
________________
Operate scavenger trucks (PTO)
________________
Orchards
________________
Planting
________________
16
Number of hours used for backhoe digging
________________
Silage
________________
Spray chemicals applied
________________
17
Number of loads
Straw baling
________________
Augering dry cement
Spray fertilizer
________________
____________________________________
Blowing dry cement
Replanting
________________
____________________________________
Reseeding
________________
18
Tons of dry fertilizer applied
Treatment for corn borers,
Limestone
________________
earthworms, or weeds
________________
Phosphate
________________
Truck farming
________________
19
Dry fertilizer
Bushels of
Tons applied
________________
Corn shelling
________________
or
Tons of
Acres of application
________________
Feed ground
________________
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Tons of liquid fertilizer applied
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Mixed
Other nonhighway gasoline usage not identified above
____________________________________
Nitrate
____________________________________
(please detail)
___________________________________________________________________________________________
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Acres to which liquid fertilizer was applied
Anhydrous ammonia
____________________________________
__________________________________________________________________________________________________________________
NH
____________________________________
3
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
RMFT-11-A Page 2 of 4 (R-8/05)
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