Form Mfd 21 - Tax Computation - 21-Retail Dealer Sales To Us Government (Page 2 of 2) in pdf

Form Mfd 21 - Tax Computation - 21-Retail Dealer Sales To Us Government Page 2

INSTRUCTIONS

“TAX COMPUTATION”

MFD SCHEDULE 21-RETAIL DEALER SALES TO US GOVERNMENT

(As defined for line 21 of the MFD 1-S/AF report)

This form is required by RSA 260:38, I and is designated as Form MFD 21. It is to be completed by an authorized representative and shall include the

following information:

Distributor Name

Federal Employer Identification Number (FEIN)

Period covered

Indicate if more than one page is used for a schedule

Each United States Government Agency name must be listed. Delivery date gallons by retailer as well as product type and gallons

sold must be given. The term “various” for these items is NOT ACCEPTABLE

The total gallon for the page is to be shown. If more than one page is used for the individual schedule, the FINAL page of that schedule will

contain the amount to forward to line 21 on the MFD 1-S/AF report.

Tabulated computer listings containing the above data may be used, when approved, but must be attached to the appropriate schedule.

RSA 260:38 Determination and Payment of Road Toll.

I. For the purpose of determining the amount of road toll imposed and to be collected under this subdivision, each distributor shall on or before the

twentieth day of each calendar month render a return to the department on forms prescribed and furnished by the commissioner. The return shall show the

total number of gallons sold and used in the state during the previous calendar month together with such other information as the commissioner may

require for the reasonable administration of this subdivision. Each distributor shall accompany the return with a check payable to the state treasurer for the

total amount of road toll shown by such return to be due.

FORMS MFD 21 (Revised 11/06)