Form 82-010 - Transport Diversions To Points Outside Iowa printable pdf download

Iowa Department of Revenue

Transport Diversions to Points Outside Iowa

82-010 (04/02/10)

Send this claim to: Iowa Department of Revenue

Name of

Motor Fuel Unit

Claimant ____________________________

Examination Section

Attach to Form 82-006

P.O. Box 10456

FEIN _______________________________

Des Moines, IA 50306-0456

or Fax to: 515-281-3756, E-mail: idrmotorfuel@iowa.gov

Terminal Operator Name:

IRS Terminal Code:

Terminal City and State:

New Destination:

Original Destination:

Supplier Name:

Supplier City and State:

Recipient Name:

Recipient City and State:

Carrier Name:

Carrier FEIN:

Bill of Lading Number:

Bill of Lading Date:

Product Type:

Gross Gallons:

Reason for Diversion:

Include supporting documents

carriers may choose another reporting option when transporting fuel from a

When a transport load of fuel is sold Iowa tax-paid with an Iowa-

refinery or marine or pipeline terminal on behalf of a licensee. If pre-approved,

designated destination, and later diverted to a destination outside the state,

they may instead carry in the vehicle a loading invoice showing the name and

the person who actually paid the Iowa tax is entitled to a refund. To receive

address of the seller or consignor, the date and place of loading and the type and

the refund, the person must complete and file this form with supporting

quantity of fuel loaded. Invoices showing the type and quantity of each delivery

documentation. Supporting documents include a copy of the bill of

lading (manifest), invoices or documents showing where and to whom

and the name and address of each purchaser or consignee must also be carried in

the fuel was delivered, a copy of the reporting form and evidence of

the vehicle.

Supplier is defined as a person who:

payment to the state where the fuel was actually delivered.

· acquires fuel by pipeline or marine vessel for storage at and distribution

Terminal operator is defined as the person who - by ownership or

from a terminal, and who is registered under 26 U.S.C. § 4101 for tax-free

contractual agreement - is charged with responsibility for, or physical control

transactions in gasoline, or

over the operation of a terminal.

· produces alcohol or alcohol derivative substances in this state or acquires same

A serially-numbered manifest must be carried on every vehicle (except

by truck, railcar, or barge for storage at and distribution from a terminal, or

small tankwagons) while in use in transportation service. The manifest must

· produces or acquires biofuel or biodiesel for storage at and distribution from a

include the following information about the fuel being moved: the date and

place of loading, the place to be unloaded, the person for whom it is being

terminal, or

delivered, the type of product and the quantity of product. The manifest for

· produces, manufactures, or refines fuel in this state, or

· does not meet the jurisdictional connection to this state but voluntarily agrees

small tankwagons must be retained at the home office. Upon delivery, the

to act as a supplier for purposes of collecting and reporting the fuel tax.

manifest must be completed by entering the date and place of actual delivery

and the person to whom actually delivered. With the department’s approval,

Form 82-010 - Transport Diversions To Points Outside Iowa

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