Schedule Pda-49q - Special Fuel Qualifying Service Station Adjustment

Download a blank fillable Schedule Pda-49q - Special Fuel Qualifying Service Station Adjustment 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 Schedule Pda-49q - Special Fuel Qualifying Service Station Adjustment 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.

PDA-49Q

Special Fuel Qualifying Service Station Adjustment

List undyed diesel fuel sales to qualifying service stations. Enter state:

(Complete a separate PDA-49Q for each state)

Company name

Minnesota tax ID number

Address

Master jobber

City

State

Zip code

Sold To/Purchased From

Mailing Address

Town Delivered To

Date

Ticket Number

Gallons

Total gallons

1 Evaporation and loss allowance (multiply total gallons by 1 percent [.01] ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

2 Net gallons subject to rate reduction (subtract line 1 from total gallons) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

3 Tax rate reduction per gallon (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

4 Tax adjustment (multiply lines 2 and 3). Enter the result here and on Form PDA-49, line 12 . . . . . . . . . . . . . . . . . . . . . . 4 $

Phone: 651-296-0889 (TTY: Call 711 for Minnesota Relay). Email: petroleum.tax@state.mn.us

(Rev 3/13)