Form 3712 - Motor Fuel Tax License Application Page 6
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7Form 3712, Page 6
51. Will you import fuel products, excluding ethanol, from a bulk plant in another state by Tank Wagon or railcar?
Yes
No
PART 8 – EXPORT LICENSE
Yes
No
52. Do you plan to export petroleum products from the State of Michigan?
a. Indicate the type of petroleum products exported from the State of Michigan.
Gasoline Products
Diesel Products
Aviation Products
Misc. Products
Gasoline (065)
Ethanol (241)
Dyed Diesel (228)
Aviation Gasoline (125)
Other:_______________
Gasohol (124)
Methanol (243)
Clear Diesel (160)
Jet Fuel (130)
Other _____________________________
K1 Kerosene (142)
b. Indicate the means of transport for this exported product (check all that apply)
Pipeline
Transport Truck
Railroad
Tank Wagon
Barge/Ship
Other (describe): ____________________________________________________
c. List the states, countries or provinces to which you export petroleum products and attach copies of applicable licenses from the state, country, or
province of destination. If a license is not required by the state, country, or province of destination, indicate with N/A.
Fuel Type
Indicate State(s), Country(ies) and/or Province(s)
Gasoline (065)
Clear Diesel (160)
Dyed Diesel (228)
Aviation Gasoline (125)
Jet Fuel (130)
PART 9 – BLENDER LICENSE
53. Do you blend products that are not otherwise subject to motor fuel tax with motor fuel products?
Yes
No
If yes, list products
Will you blend with more than one motor fuel product?
Yes
No
Check all fuel types used for blending
Gasoline
Diesel
Aviation Fuels
Other:_______________________
PART 10 – TRANSPORTER LICENSE
54. Do you transport fuel into or out of the State of Michigan for hire?
Yes
No
55. Indicate Method(s) of Transport
Truck
Rail
Other: ________________________________________________
IFTA Jurisdiction (if transporting by truck)
Account Number (if transporting by truck)
PART 11 – RETAIL DIESEL WATERWAYS LICENSE
56. Do you sell diesel fuel into fuel supply tanks of watercraft?
Yes
No
PART 12 – LIQUEFIED PETROLEUM GAS LICENSE
Yes
No
57. Do you sell liquefied petroleum gas for motor vehicle use or into supply tanks of highway vehciles?
58. Do you have LPG storage from which both highway and non-highway fuel is disbursed?
Yes
No
59. Do you withdraw LPG from the cargo tanks of trucks, trailers or semi-trailers for the operation of a motor vehicle?
Yes
No
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