Form B&l: Mft-Prou - Petition For Refund
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1
2A
D
R
LABAMA
EPARTMENT OF
EVENUE
B
& L
T
D
RESET
B&L: MFT-PROU
USINESS
ICENSE
AX
IVISION
5/16
M
F
S
OTOR
UELS
ECTION
P.O. Box 327540 • Montgomery, AL 36132-7540 • (334) 242-9608 • Fax (334) 242-1199
Petition For Refund
For Other Refund Provisions as Listed in Section 40-17-329(d), (g), (i), (k), or (l)
NAME
PERIOD
ADDRESS
LICENSE NUMBER (IF APPLICABLE)
CITY
STATE
ZIP
FEIN
CONTACT PERSON
TELEPHONE NUMBER
( )
E-MAIL ADDRESS
Check here if new address
TYPE OF REFUND: (check one)
Licensed Aviation Fuel Purchaser sales to air carrier for all cargo international flights (Jet Fuel Only) (Monthly)
Air carriers with a hub operation (Jet Fuel Only) (Quarterly)
Gasoline blendstocks not used in the manufacture of gasoline or as a motor fuel (Gasoline Only) (Quarterly)
Transmix not used as a motor fuel or that is delivered to a refinery for further processing (Quarterly)
Tax paid on motor fuel within the bulk transfer system in which a second tax has been paid or exported to another state or country
(Monthly)
1. Total gallons
TAX REFUND CALCULATION:
Gasoline
Undyed Diesel
Aviation Gas
Jet Fuel
(round to whole gallons). . . .
2. Excise tax rate . . . . . . . . . . .
X $0.18
X $0.19
X $0.095
X $0.035
3. Refund Total
(line 1 multiplied by line 2) . . $
$
$
$
I declare under the penalties of perjury that this claim has been examined by me and to the best of my knowledge and belief is true and
correct, and that the number of gallons claimed are correct, and that said petitioner is entitled to such refund under the provisions of
Section 40-17-329(d), (g), (i), (k), or (l).
Signature: _________________________________________________________________ Date: ____________________________
Title or Position: ______________________________________________________________________________________________
Records to clearly substantiate the above petition must be maintained by the claimant for a period of six years and must be made
available to the Alabama Department of Revenue or its authorized agents upon request. The statute of limitations is two years from the
date the purchase was made by the claimant. The petition must be filed on either the quarterly or monthly basis as stated in the refund
provisions and cannot include any other period. Copies of invoices showing that the tax was paid and any other documentation to
substantiate the claim must be attached to the petition for refund. Please see instructions for further details.
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Parent category: Financial