Form Sfr-1032 - Application For Special Fuel Tax Refund (Page 2 of 2) in pdf

Form Sfr-1032 - Application For Special Fuel Tax Refund Page 2

Before a Refund Can Be Authorized All Applicable

Areas Below Must Be Completed

SECTION III: SPECIAL FUEL CONSUMING EQUIPMENT

List all equipment consuming special fuel, including licensed vehicles, non-highway equipment, agricultural equipment and building construction

equipment. Indicate the total gallons of special fuel consumed, by vehicle and/or equipment type, during the period for which the refund is claimed.

TYPE

MAKE

LICENSE NUMBER

MODEL

AMOUNT OF SPECIAL FUEL USED

Gals.

Total Gallons

(Attach additional list if space is not sufficient).

SECTION IV: SPECIAL FUEL USED IN AGRICULTURAL PRODUCTION

NUMBER OF ACRES OWNED OR RENTED FOR USE BY APPLICANT __________________ ACRES UNDER CULTIVATION _____________

ACRES CUSTOM-FARMED THAT ARE NOT OWNED OR RENTED BY THE APPLICANT ___________________________________________

Total

Crop

Operations

Crop

Acreage

Indicate the type of crops farmed, the acreage per crop and the total

For Each Crop

number of operations performed for each crop listed (attach additional

list if space is not sufficient).

LIST THE NUMBER OF GALLONS OF SPECIAL FUEL CONSUMED IN OTHER FARM OPERATIONS, SUCH AS FUEL USED

IN THE CARE OF LIVESTOCK, TO GRIND FEED, TO PUMP WATER, ETC. (Describe these uses in detail. Be certain to indicate the

number and type of livestock.)

SECTION V: OTHER EXEMPT USES

Other Exempt Uses (Provide detailed explanation)

Form Sfr-1032 - Application For Special Fuel Tax Refund Page 2