Form 04-544 - Claim For Refund Motor Fuel Tax - Alaska Department Of Revenue Page 4

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Alaska Department of Revenue
Claim for Refund
Schedule of Jet Fuel Used in Foreign Flights
(Air Carriers Only)
Range of Dates for Fuel Purchased
Name:___________________________________________
From:
/
/
To:
/
/
EIN:
___________________________________________
Include only jet fuel gallons used in foreign flights. Foreign flights are defined as flights going directly to a foreign country
(without intermediate stops within the United States) or flights continuing from a foreign country.
Date of
Flight
Location of Flight
First Stop After
Foreign Flight
Flight
Number
Origination
Fueling in Alaska
Jet Fuel Gallons
Total Gallons (Carry forward to page 1, line 8)
Attach this schedule to your Claim for Refund. Use additional sheets as necessary.
Form 04-544.3 (Rev 04/01)

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