Form Rmft-17 - Ust/eif Exemption For Sales Of Aviation Fuels, Kerosene, And Diesel Fuel - Illinois Department Of Revenue

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Illinois Department of Revenue
Page ____ of ____
Schedule LB
UST/EIF Exemption for Sales of
Aviation Fuels, Kerosene, and Diesel Fuel
Attach to Form RMFT-5-US
Step 1: Complete the following information
______________________________________________
Check the product type you are listing on this page.
Company name
Diesel fuel sold to railroads
______________________________________________
Diesel fuel sold to qualified ships, barges, and vessels
Your license number
Kerosene sold to qualified air carriers
Reporting period __ __/__ __ __ __
Aviation fuel sold to qualified air carriers
Month
Year
1-k kerosene sold to qualified air carriers
Step 2: Report your exempt sales
1
2
3
4
5
6
7
8
Invoice date
Invoice
Name of
Bill of lading or
Airport name
Destination
Invoiced
number
carrier
manifest number
Name of purchaser
(sales to air carriers only)
(Illinois cities only)
gallons
(month, day, year)
1
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
2
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
3
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
4
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
5
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
6
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
7
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
8
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
9
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
10
_ _/_ _/_ _ _ _ _____________________________________________________________________________________________________________________________________
11 Add the invoiced gallons in Column 8, Lines 1 through 10. Write the total amount here.
11
___________________
12 If you are filing only one Schedule LB, write the amount from Line 11 here. If you are reporting
• diesel fuel sold to railroads, also write this amount on Form RMFT-5-US, Line 6a, Column 1.
• diesel fuel sold to ships, barges and vessels, also write this amount on Form RMFT-5-US, Line 6c, Column 1.
• kerosene sold to air carriers, also write this amount on Form RMFT-5-US, Line 6b, Column 1.
• aviation fuel or 1-k kerosene sold to air carriers, also write this amount on Form RMFT-5-US, Line 6b, Column 2.
12
___________________
If you are filing more than one Schedule LB, see instructions.
RMFT-17 front (R-09/01)

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