Form Wv/mft-509pto-Gas - Motor Fuel Excise Tax Refund Application

WV State Code §11-14C:

State law provides for a refund of the Motor Fuel Excise Tax – Flat Rate ($.205) when a motor vehicle with

auxiliary equipment uses motor fuel and there is no auxiliary motor for the equipment or separate tank for a motor.

A refund for the fuel used in operating a power take-off unit on a cement mixer truck or garbage truck is allowed

equal to twenty-five percent (25%) of the flat rate tax ($.205) on all motor fuel used in such truck(s).

POWER-TAKE OFF 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. If you do not have a West Virginia

Identification Number, enter your Federal Employer Identification Number. If you do not have a West Virginia

Identification Number or a Federal Employer Identification Number, enter your Social Security Number.

Applicants Name and Address: Complete all requested information. Checks will be issued to the applicant at

the address as shown on this application.

Contact Person: Provide someone who can discuss the application if necessary.

NOTE: This refund application is only for cement mixer trucks and garbage trucks; any other PTO use

does not qualify for a refund.

Check the box if you are filing an Off-Highway Application and a Power Take-Off Application. Attach

receipts with the off-highway application.

Indicate the type of truck using a power take-off unit.

FUEL ACCOUNTABILITY:

•

Gasoline must be purchased in quantities of twenty-five (25) gallons or more, each time gasoline is

purchased, for use as a motor fuel in internal combustion engines not operated upon highways of this

state.

•

Gasoline must be consumed and refund application must be filed within the quarter as listed on the front

of the application.

•

Attach original or duplicate original invoice. Certified copies of sales slips, invoices, billing statements,

and electronic invoices are acceptable in lieu of original invoices at the discretion of the Tax

Commissioner.

•

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.

•

Inventory is determined for timely filing by the date(s) of the invoice(s) making up the inventory.

•

Inventories must be used within the quarter.

•

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.

The Motor Fuel Excise Tax – Variable Rate of $.0650 is not refundable for this use.

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.

Should you have any questions, please contact one of the following:

Carol Brown

Donald Butler

(304) 558-8627

(304) 558-8623

cbrown@tax.state.wv.us

dbutler@tax.state.wv.us

Beverly Segsworth

Donna Purdy

(304) 558-8624

(304) 558-8625

bsegsworth@tax.state.wv.us

dpurdy@tax.state.wv.us

Crystal Ellington

(304) 558-8626

cellington@tax.state.wv.us

Form Wv/mft-509pto-Gas - Motor Fuel Excise Tax Refund Application - 2005 Page 2

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