Form Mf 100a - Fuel Tax License Application Page 3

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Fuel Tax License Types
The following statements describe the activities of each license. Check the areas that apply to your business activity.
! ! ! ! !
IS – In-State Supplier: Owns fuel within a pipeline system and can withdraw that fuel or authorize its withdrawal at the terminal
within South Dakota. Must also be licensed as a Positionholder with the Internal Revenue Service. Please provide the IRS license number
____________________. Please list the terminals from which you are operating in South Dakota. This is a mandatory license. Attach
additional sheets if necessary.
Name
Telephone number
Address
City
State
Zip Code
! ! ! !
!
OS – Out-of-State Supplier: Own fuel within a pipeline system and can withdraw that fuel or authorize withdrawal from a terminal
located outside of South Dakota. Must also be licensed as a Positionholder with the Internal Revenue Service. Please provide the IRS
license number__________________. Please list the terminals from which you are operating outside of South Dakota. This is a voluntary
license. Attach additional sheets if necessary.
Name
Telephone number
Address
City
State
Zip Code
!
IM – Importer: Owns fuel which is transported into South Dakota from another state or country for sale or delivery by truck, rail car
or any means other than pipeline.
! ! ! !
!
EX – Exporter: Owns fuel which is transported from South Dakota into another state or country for sale or delivery by truck, rail car
or any means other than a pipeline. Must be licensed either to collect and remit fuel taxes or be licensed to deal in tax free fuel in the other
specified state(s) to which the fuel is exported. Attach additional sheets if necessary.
States export to
License number assigned by that state
States export to
License number assigned by that state
! ! ! !
!
BL – Blender: Blends fuel products to create other fuels such as gasohol, E85 or M85. No license is required to purchase product
whose bill of lading indicates a 10% ethanol blend (gasohol) and the bill of lading does not indicate the alcohol and gasoline as separate
products.
! ! ! !
!
CV – CNG Vendor: A utility company that is regulated by the Public Utilities Commission that sells compressed natural gas for use
in motor vehicles.
! ! ! !
!
LV – LPG Vendor: Sells liquid petroleum gas for use in motor vehicles, or sells to other LPG Vendors that are selling LPG product
for motor vehicle usage.
! ! ! !
!
EP – Ethanol Producer: Produces ethyl alcohol in South Dakota that is 99% pure and distilled from cereal grains for sale, use or for the
purpose of making ethanol blends.
! ! ! !
!
HC – Highway Contractor: Performs construction, reconstruction, repair or maintenance on publicly funded highways and roads in
South Dakota, including township work and snow removal.
! ! ! !
!
LU – LPG User: A person who uses liquid petroleum gas in the engine fuel supply tank of a motor vehicle and wishes to purchase the
fuel on a tax unpaid basis. Or a person that is purchasing liquid petroleum fuel for multiple uses which are subject to different taxes. If you
are licensed as a highway contractor, regardless if you have a LPG powered vehicle, licensing as a LPG user is not required.
! ! ! !
!
TR – Transporter: Provides transportation of fuel in quantities over 4,200 gallons within South Dakota or to areas outside the state by
transport truck, rail car or means other than a pipeline.

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