State of New Jersey
MFT-10
Division of Taxation
MOTOR FUELS TAX
SELLER-USER OF SPECIAL FUELS REPORT
For Return Periods Ending July 1995 and Thereafter
For the month of ____________________________________ , __________
DUE DATE:
Must be received on or before 20th of the
FID #___________________________________________________________________________
month following the report month.
Make Check
________________________________________________________________________________
Name
Payable To:
“State of New Jersey - MFT”
________________________________________________________________________________
Mail with
Division of Taxation
Address - Number & Street
report to:
Revenue Processing Center
PO Box 243
________________________________________________________________________________
City
State
Zip Code
Trenton, NJ 08646-0243
USE WHOLE GALLONS ONLY
1. Total Receipts of Special Fuels
(Must detail on Schedule A on reverse side) . . . . . . . . . . . .
2. Total Gallons Sold and/or Used . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Non-Taxable Sales
(Must Detail on Schedule B, (a) on reverse side) . . . . . . . .
4. Non-Taxable Use
(Must Detail on Schedule B, (b) on reverse side) . . . . . . . .
5. Total Non-Taxable Sales or Use
(Add Lines 3 and 4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6. Taxable Sales & Use
(Must Detail on Schedule C on reverse side) Line 2 minus Line 5 . . . . . . . . . . . . . . . . . . . . . .
7. Gross Tax Due on Special Fuels
(Multiply Gallons on Line 6 by $0.135 cents per gallon) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
8. Tax Due on Liquified Petroleum
Gas (LPG) Gallons _________________________ x .0525. Enter result here . . . . . . . . . . . .
$
9. Total Tax Due
(Add Lines 7 and 8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
10. Penalty and Interest (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
11. Amount Due
(Add Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
REVERSE SIDE OF THIS FORM MUST BE COMPLETED
I declare, under the penalties provided by law, that all of the information contained in this return and in all schedules and statements in support of it is
true and accurate in every particular.
___________________________________________________________________________________________________________________________
Signature of Authorized Officer of Taxpayer
Title
Date
___________________________________________________________________________________________________________________________
Signature of Individual or Firm Preparing Return
Federal Identification Number
Date
THIS FORM MAY BE REPRODUCED