Form 735-9740c - International Fuel Tax Agreement (Ifta) Tax Return
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4OREGON DEPARTMENT OF TRANSPORTATION
RESET
PRINT
MOTOR CARRIER TRANSPORTATION DIVISION
3930 FAIRVIEW INDUSTRIAL DRIVE SE
SALEM OR 97302-1166
PH (503) 373-1634
INTERNATIONAL FUEL TAX AGREEMENT (IFTA) TAX RETURN
DO NOT WRITE IN SPACE ABOVE
OPERATIONS DURING THE QUARTER:
CHECK THE BOXES BELOW IF THEY APPLY:
RETURN DUE:
OREGON ACCOUNT NUMBER
IFTA LICENSE NO.
AMENDED
YOU HAD NO OPERATIONS TO REPORT
YOU HAD OREGON OPERATIONS ONLY
OREGON MILES
FUEL TYPE
TOTAL GALLONS PURCHASED IN OREGON
CHANGE OF ADDRESS
IFTA CREDIT REFUND REQUEST
FUEL / MILES
+
=
=
:
Column 1
Column 2
Column 3
Column 4
Column 5
SUMMARY
TOTAL MILES TRAVELED
NON-IFTA JURISD.MILES
TOTAL MILES
TOTAL GALLONS OF FUEL
AVERAGE FLEET MPG
FUEL TYPE
(ALASKA, YUKON TERRITORY, NW
(placed in fuel tanks of all
(in IFTA Jurisdictions
(add Column 1 and Column 2)
+
=
=
(rounded to 2 decimal places)
:
TERRITORY, WASHINGTON D.C.,
IFTA-qualified vehicles from
and Oregon - includes permit
HAWAII)
all jurisdictions including Oregon)
and off-road miles)
+
=
:
=
Diesel
+
=
:
=
Biodiesel
+
=
=
:
Gasoline
+
=
:
=
OTHER
E
F
G
B
C
D
H
I
J
K
A
FUEL
TAXABLE
TAXABLE
NET TAXABLE
TAX
TAX DUE
INTEREST
TOTAL DUE
TOTAL MILES
TAX PAID
JURIS.
TYPE
GALLONS
GALLONS
RATE
OR (CREDIT)
DUE
IN
MILES IN
OR (CREDIT)
GALLONS
(D, G,
JURISDICTION
(E minus F)
(I plus J)
JURISDICTION
(D : avg mpg)
ETC)
AL
AB
AZ
AR
BC
CA
CO
CT
DE
FL
GA
ID
IL
IN
IN
SURCHARGE
IA
SUB TOTALS
(FRONT PAGE)
SUB TOTALS
(BACK PAGE)
GRAND
TOTAL
6
TOTAL FUEL TAX AND
I CERTIFY UNDER PENALTY OF PERJURY, THAT THIS RETURN IS TRUE, CORRECT, AND
INTEREST DUE OR (CREDIT)
COMPLETE TO THE BEST OF MY KNOWLEDGE.
7
PREVIOUS BALANCE DUE
SIGNATURE OF OWNER, PARTNER, CORP. OFFICER OR EMPLOYEE
TITLE
DATE
8
PREVIOUS CREDIT
9
PENALTY
NAME OF PERSON TO CONTACT ABOUT THE RETURN
TELEPHONE
(
)
10
REINSTATEMENT FEE
11
FORM 735-9740 (7-16)
TOTAL BALANCE DUE
JURISDICTIONS CONTINUED ON REVERSE
OR (CREDIT)
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