Form Mf-7 Petroleum Products Inspection Report - 2006
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2KANSAS DEPARTMENT OF REVENUE
CUSTOMER RELATIONS
915 SW HARRISON ST.
TOPEKA, KANSAS 66625-8000
Phone Number: (785) 368-8222
Fax: (785) 296-4993
PETROLEUM PRODUCTS INSPECTION REPORT
For month of
,
NOTE: This report must be prepared for
each calendar month, and filed not later
than the 25th of the following month.
PETROLEUM PRODUCTS INSPECTION FEE
1. Gasoline and Diesel Instate (from schedule on reverse side) .............................................................
__________________
2. Gasoline and Diesel Imported (from schedule on reverse side) ..........................................................
__________________
3. Total gallons of liquid fuels subject to inspection fee (Add lines 1 and 2) ............................................
__________________
4. Total barrels subject to inspection fee (total gallons line 3 divided by 50) ...........................................
__________________
5. Petroleum Products Inspection fee at 1.5 cents ($.015) per barrel......................................................
$_________________
6. Penalty at 5% plus appropriate % of interest per month as found on our web site, for delinquent filing
$_________________
7. Total Petroleum Products Inspection fee, penalty and interest............................................................
$_________________
ENVIRONMENTAL ASSURANCE FEE
8. Total gallons of petroleum products manufactured or imported...........................................................
__________________
9. Less exports shipped directly ..............................................................................................................
____________
10. Total gallons of petroleum products subject to assurance fee.............................................................
__________________
11. Assurance fee at $.01 per gallon (line 10 times $.01) .........................................................................
$
When line 11 is marked out (XXXXXXXXXX) do not remit the environmental assurance fee.
12. Penalty at 5% plus appropriate % of interest per month as found on our web site, for delinquent filing
$_________________
13. Total Assurance Fee, penalty and interest ..........................................................................................
$_________________
14. TOTAL AMOUNT REMITTED.............................................................................................................
$_________________
INSTRUCTIONS
Petroleum Products Inspection Fee
1.
Line 1: All gasoline and diesel gallons first sold, offered for sale, used or delivered in the state of Kansas, including fuel that has been
exported, sales of aviation/jet fuel and sales to the U.S. government.
2.
Line 2: All gasoline and diesel gallons imported into the state of Kansas.
Environmental Assurance Fee
3.
"Petroleum" means petroleum, including crude oil or any fraction thereof, which is liquid at standard conditions of temperature and pressure
(60 degrees Fahrenheit and 14.7 pound per square inch absolute) including, but not limited to, gasoline, gasohol, diesel fuel, fuel oils, kerosene
and biofuels.
4.
"Petroleum Product" means petroleum other than crude oil.
Signature
Telephone No.
MF-7
(Rev. 5/06)
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