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WV State Code §11-14C:

State law provides for a refund of the Motor Fuel Flat Rate Tax of $.205 and Variable Rate tax of $.0485 (combined rate of $.2535)

on all gallons of special fuel(diesel) used (consumed) in vehicles or equipment owned and operated by the following government entities or

government agencies or authorities. NOTE: Dyed special fuel is exempt from the Flat Rate Tax of $.205 when purchased;

therefore, the Variable Rate Tax of $.0485 is the only refundable tax.

United States or any agency thereof;

County Government or unit or any agency thereof;

Municipal Government or any agency thereof;

County Boards of Education;

Urban Mass Transportation Authorities

Bona Fide Volunteer Fire Departments, Nonprofit Ambulance Service or Emergency Rescue Services

Any municipal, county, state or federal civil defense or emergency service program pursuant to a government

contract for use in conjunction therewith, or to any person on whom is imposed a requirement to maintain an

inventory of special fuel for the purpose of the program.

State of West Virginia – The only allowable refundable tax is the Variable Tax Rate of $.0485. You must use

Form WV/SPF-509V-State.

REFUND INFORMATION AND INSTRUCTIONS

Failure to comply with the instructions or failure to complete the application may result in the disallowance of the refund, a delay

in payment, or reduction in the refund amount requested.

The application must be completed timely and accurately. Any

application for a refund not timely filed is not construed to be or constitute a moral obligation of the State of West Virginia for

payment. Incomplete forms or late-filed applications will be returned.

WV Identification Number: Enter your West Virginia Identification Number or Federal Identification Number, whichever is

applicable. If you do not have an Identification Number, one will be assigned to your account.

Applicants Name and Address: Complete all requested information. Checks are issued in the applicants name as shown on

this application and will be mailed to the address listed as the mailing address.

Contact Person: Provide someone who can answer questions if necessary for the department to discuss the application.

Fuel Consumption: Provide a brief description of how your fuel was consumed.

FUEL ACCOUNTABILITY:

•

Attach original or duplicate original sales slip or invoice. Certified copies of sales slips or invoices are acceptable.

Copies, third party billing statements or sales slips/ invoices marked “duplicate” are not acceptable.

•

Invoices must provide complete details of the purchase.

Name and address of supplier, name and address of

purchaser, date of purchase or delivery, product purchased, number of gallons purchased and the price of product.

•

Invoices must not be altered or erased.

•

The right to receive a refund is not assignable. No payment of the refund may be made to any person other than the

original person entitled.

•

Refund application must be submitted no later than the thirty-first (31st) day of August for purchases of motor

fuel made during the preceding fiscal year ending the thirtieth (30th) day of June.

GENERAL INFORMATION: The information provided is to assist a person filing a refund application and to possibly avoid

delays in the processing of your application. Unless it is necessary to correspond with you or your supplier for additional

information, your application will be subject for determination of payment within thirty (30) days.

Donald Butler

Donna Purdy

Carol Brown

(304) 558-8626

(304) 558-8623

(304) 558-8625

cbrown@tax.state.wv.us

dbutler@tax.state.wv.us

dpurdy@tax.state.wv.us

Tonja Oakes, Unit Manager

(304) 558-8621

toakes@tax.state.wv.us

Form Wv/mft-509v Sf - Motor Fuel Excise Tax Government Refund Application - West Virginia State Tax Department - 2003 Page 2

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