Fillable Form 4136 - Credit For Federal Tax Paid On Fuels (Page 4 of 4) in pdf

Form 4136 (2004)

Page

Line 3. Nontaxable Use of Undyed Diesel Fuel

Line 7. Sales by Registered Ultimate Vendors of

Undyed Kerosene

Caution: Line 3 cannot be used to make a claim for diesel

fuel used on a farm for farming purposes. Only registered

Claimant. The registered ultimate vendor of the kerosene is

ultimate vendors may make those claims (see line 6).

the only person eligible to make this claim. Write your UV

Claimant. The ultimate purchaser of the diesel fuel is the

registration number on the entry line if you are making a

only person eligible to make this claim.

claim on line 7a or 7b. For a claim on line 7c, write your UP

registration number on the entry line. See the Caution under

Allowable uses. For line 3a, the diesel fuel must have been

Specific Instructions on page 3.

used during the income tax year for types of use 2, 3, 6, 7,

or 8. No. 8 includes use as heating oil and use in a boat.

Allowable sales. The fuel must have been sold during the

income tax year:

Line 4. Nontaxable Use of Undyed Kerosene

● For use on a farm for farming purposes,

Caution: Line 4 cannot be used to make a claim for kerosene

● For use by a state or local government (including essential

used on a farm for farming purposes or sold from a blocked

government use by an Indian tribal government), or

pump. Only registered ultimate vendors may make those

● From a blocked pump.

claims (see line 7).

Information to be submitted. For lines 7a and 7b, attach a

Claimant. The ultimate purchaser of the kerosene is the only

separate sheet with the name and TIN of each farmer,

person eligible to make this claim.

custom harvester, or governmental unit to whom the

Allowable uses. For line 4, the kerosene must have been

kerosene was sold and the number of gallons sold to each.

used during the income tax year for types of use 2, 3, 7, or

Line 8. Nontaxable Use of Liquefied Petroleum Gas

8. No. 8 includes use as heating oil and use in a boat.

(LPG) in Certain Buses

You may claim a credit for the tax on undyed

Claimant. The ultimate purchaser of the LPG (such as

kerosene you purchased (other than from a

TIP

propane or butane) is the only person eligible to make this

blocked pump) and used in your home during

claim.

2004 for heating, lighting, or cooking.

Line 9. Gasohol Blending

To claim the credit on line 4 for home use:

1. Enter 8 in col. (a).

Claimant. The person that produced the gasohol is the only

person eligible to make this claim.

2. Enter the number of gallons of kerosene in col. (c).

3. Multiply the gallons in col. (c) by $.244. Enter the result

in col. (d).

Paperwork Reduction Act Notice. We ask for the

4. If this is the only fuel tax credit you are claiming, enter

information on Form 4136 to carry out the Internal Revenue

the amount from col. (d) on:

laws of the United States. We need it to ensure that you are

a. Line 10 of Form 4136, and

complying with these laws and to allow us to figure and

b. Line 69 of Form 1040. Also, check box b on line 69.

collect the right amount of tax.

You are not required to provide the information requested

Line 5. Nontaxable Use of Aviation Fuel

on a form that is subject to the Paperwork Reduction Act

Claimant. The ultimate purchaser of the aviation fuel is the

unless the form displays a valid OMB control number. Books

only person eligible to make this claim.

or records relating to a form or its instructions must be

Allowable uses. For lines 5b and 5c, aviation fuel taxed at a

retained as long as their contents may become material in

rate of 21.9 cents a gallon, or at a reduced rate of 4.4 cents

the administration of any Internal Revenue law. Generally, tax

a gallon, must have been used during the income tax year

returns and return information are confidential, as required by

for types of use 1, 3, 9, 10, or 11.

section 6103.

The time needed to complete and file this form will vary

Line 6. Sales by Registered Ultimate Vendors of

depending on individual circumstances. The estimated

Undyed Diesel Fuel

average time is: Recordkeeping, 19 hr., 46 min.; Learning

Claimant. The registered ultimate vendor of the diesel fuel is

about the law or the form, 6 min.; Preparing and sending

the form to the IRS, 20 min.

the only person eligible to make this claim. Write your UV

registration number on the entry line. See the Caution under

If you have comments concerning the accuracy of these

Specific Instructions on page 3.

time estimates or suggestions for making Form 4136 simpler,

we would be happy to hear from you. You can write to the

Allowable sales. The fuel must have been sold during the

Internal Revenue Service at the address listed in the

income tax year:

instructions of the tax return with which Form 4136 is filed.

● For use on a farm for farming purposes or

● For use by a state or local government (including essential

government use by an Indian tribal government).

Information to be submitted. Attach a separate sheet with

the name and TIN of each farmer, custom harvester, or

governmental unit to whom the diesel fuel was sold and the

number of gallons sold to each.

Printed on recycled paper

Form 4136 - Credit For Federal Tax Paid On Fuels Page 4

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