Form 4757 - Distributor'S Monthly Tax Report Page 4
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4The total of fuel tax, aviation gasoline fuel tax, inspection fee,
Please ensure that you sign, indicate your title, and date the report.
transport load fee, and pool bond amount should equal Line 34.
MOTOR FUEL TAX, AVIATION GASOLINE TAX, INSPECTION
FEE, TRANSPORT LOAD FEE AND POOL BOND ARE FIVE
Make check or money order payable to the Missouri Department of
SEPARATE ACCOUNTS. DO NOT USE A CREDIT ON ONE
Revenue. Mail the report and schedules to: Missouri Department of
ACCOUNT TO PAY FOR ANOTHER ACCOUNT. (EXAMPLE:
Revenue, Taxation Bureau, Excise Tax, P.O. Box 300, Jefferson
MOTOR FUEL TAX CREDIT CANNOT BE USED TO PAY
City, Missouri 65105-0300.
AVIATION GASOLINE TAX.)
If you have questions or need assistance in completing this form,
please call (573) 751-2611 or you can e-mail excise@dor.mo.gov.
You may also access the department’s web site at
to obtain this form.
This publication is available upon request in alternative accessible format(s).
MO 860-2836 (11-2006)
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Parent category: Financial