Form 4136n Nebraska Nonhighway Use Motor Vehicle Fuels Credit Page 2

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INSTRUCTIONS
WHO MUST FILE. Every individual, corporation,
schedule using the same format as the Form 4136N for the
fiduciary, partnership, limited liability company, or S
months in the next calendar year of the taxpayer’s fiscal
corporation which is properly licensed must complete Form
year. The applicable credit rate must be requested from the
4136N to claim a refundable credit for nonhighway use of
Motor Fuels Division. If the prior calendar year’s purchases
motor vehicle fuels (e.g., gasoline and gasohol).
are included on Form 1065N or Form 1120-SN, the
appropriate Form 4136N for that year must be attached to
Individuals, Corporations, and Fiduciaries must file
the current year’s filing.
Form 4136N to claim nonhighway use motor vehicle fuels
Permitholders may file a claim each month for tax credit
credit. Partnerships, Limited Liability Companies,
motor vehicle fuels purchased during the preceding month
and S Corporations cannot claim the credit for
when they are entitled to an annual tax credit in excess of
nonhighway use motor vehicle fuels. The qualified
$60,000, based on claims filed for the preceding tax year.
purchases are distributed to the partners, members, or
shareholders who may claim the credit.
PERMIT REQUIRED FOR NONHIGHWAY USE
MOTOR VEHICLE FUELS. The actual purchaser of the
CLAIMING THE CREDIT. This form must be completed
fuels must obtain a permit prior to purchasing fuels
and attached to the income tax return filed by an individual,
qualified for this credit. This permit is obtained by
fiduciary, or corporation to claim the credit. Partners,
completing the Nebraska Permit Application to Purchase
members, or shareholders may claim a credit by attaching
Nonhighway Use Motor Vehicle Fuels, Form 83, and
the partnership’s, limited liability company’s, or S
mailing it to the Nebraska Department of Revenue along
corporation’s Form 4136N to their return. Send the return
with the $10 fee. This application may be obtained from the
and attached form to the Nebraska Department of Revenue,
department’s Web site: , or by calling
P.O. Box 94818, Lincoln, Nebraska 68509-4818.
1-800-742-7474 (in Lincoln call 471-5729). Permits must
Fiscal year filers must file this form for the calendar year in
be renewed by January 1 of every third calendar year.
which their fiscal year begins. Complete and attach a
Current permits were renewed effective January, 2001.

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