International Fuel Tax Agreement Tax Return Form 2001 - South Dakota Department Of Revenue

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SOUTH DAKOTA
Reporting Period: 200104
Ending Period: 12/31/2001
Return Due Date: 01/31/2002
License Number:
Fuel Type: D
A.
Total Miles Traveled in all
INTERNATIONAL FUEL TAX AGREEMENT TAX RETURN
States
B.
Total Fuel Consumed in all
States
C.
*Average Miles/Gallon (Line
A Divided by Line B)
Name:
South Dakota Department of Revenue
Mail To:
Remittance Center
Address:
PO BOX 5055
City, State, Zip:
Sioux Falls, SD 57117-5055
A RETURN MUST BE FILED EVEN IF NO MILES TRAVELED
1
2
3
4
5
6
7
8
9
10
Total Taxable
Tax Paid
Interest Due
Taxable Gallons
Net Gallons
Tax Due/Credit
Tot Due/Credit
Jurisdiction
Total Miles
Tax Rate
Miles
Gallons
.0100
(Col 3/Line C)
(Col 4- Col 5)
(Col 6 x Col 7)
(Col 8 + Col 9)
0.2200
SD
0.2172
AB
0.1700
AL
0.2250
AR
0.2600
AZ
0.2775
BC
0.2710
CA
0.2050
CO
0.1800
CT
0.2200
DE
0.2797
FL
0.1108
GA
0.2250
IA
0.2500
ID
0.2960
IL
0.1600
IN
0.1100
I2
0.2300
KS
0.1200
KY
0.0520
K2
0.2000
LA
0.2100
MA
0.2630
MB
Page 1
Total IFTA Miles Page 1
TOTAL OF COLUMN 10 Page 1
Page 2
Total IFTA Miles Page 2
TOTAL OF COLUMN 10 Page 2
SUBTOTAL
Total IFTA Miles
GRAND TOTAL COLUMN 10
PENALTY - 10%of Tax Due or
ADD
Total Mileage of all NON-IFTA States and Provinces
$50.00, whichever is greater
GRAND
(+ or -) Balance Due/Credit from
Total All Miles Traveled (Same as (A) above)
TOTAL
Prior Return
TOTAL DUE
* When calculating your average miles per gallon, extend two decimals only (ex. 2.86)
**When recording gallons, round up to the nearest whole gallon (ex. 52.8 = 53)
TOTAL REMITTED
I CERTIFY THAT THIS REPORT IS TRUE, CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE
TO CANCEL IFTA LICENSE, ATTACH IFTA PERMIT AND GIVE LAST DATE OF
OPERATION __________________
DATE
SIGNATURE – LICENSEE
NOTE: Please see information on Page 2
PHONE NO.
TITLE
Note: Please photocopy this return for your records. Please use black ink.
Page 1

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