Form 81-010 - Iowa Fuel Tax Return - Iowa Department Of Revenue
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1
2Iowa Department of Revenue
IOWA FUEL TAX RETURN
81-010
(7/19/07)
If new address, check this box.
License No.
Tax Period
Due Date
For Suppliers, Restrictive Suppliers,
Importers and Blenders
This form is for Iowa Tax Amnesty use only.
1 Total Gross Gallons of DIESEL FUEL
(include both dyed and undyed)
2 Total Gross Gallons of DIESEL FUEL
(dyed only)
REPORT IN WHOLE GALLONS ONLY
Computation of Fuel Tax Due
F
G
E
C
A
B
D
Aviation
Special Fuel
Aviation
E85
Jet
Gasoline
Gasohol
Alcohol
Undyed
Gasoline
3 Total Gross Gallons
3
4 Total Gross Gallons Exported. Complete Schedule 81-015
4
5 Subtract line 4 from line 3
5
.016
.016
.016
.016
.007
.007
.016
6
6 Distribution Allowance. Supplier Only
7 Multiply line 5 by line 6 for each column
7
8 Total Taxable Gallons. Subtract line7 from line 5
8
.21
.19
.03
.225
.08
.17
.19
9 Fuel Tax Rates per Gallon
9
.00
.00
.00
.00
.00
.00
.00
10 Tax Due per Fuel Type. Multiply line 8 by line 9
10
REPORT WHOLE DOLLARS ONLY
.00
11 Fuel Tax Due. Add columns 10A, 10B, 10C, 10D, 10E, 10F and 10G
11
Office Use Only
.00
12 Supplier Uncollectible Account Credit/Blenders Credit
12
.00
13 Total Fuel Tax Due. Subtract line 12 from line 11
13
.00
14 Penalty is not applicable for Iowa Tax Amnesty.
14
Check this box if this is
15 Interest if applicable. See instructions on reverse side
15
an amended return.
16 Total Amount Due. Add lines 13, 14, 15
16
Attach the correct
schedules.
17 Total EFT payment(s) made for this tax period
17
18 Balance: Subtract line 17 from line 16
18
I certify under penalty for false certification that this is a true and accurate report.
_______________________________
_______________________________
_____________
___________________
_________
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TITLE
PHONE NUMBER
DATE
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