Form 3712 - Motor Fuel Tax License Application 2009 Page 5
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8Form 3712, Page 5
PART 9: EXPORTER INFORMATION
If no, skip to Part 10.
Yes
No
50. Will you export fuel products, including biodiesel, from the state of Michigan?
Indicate the jurisdiction to which you will export, the type of fuel license you hold for that state or country/province, and the fuel products you will
export. You must also attach a copy of your license for each jurisdiction.
Country/Province
License Type
Products to be exported (see instructions for a list of product codes)
PART 10: BLENDER INFORMATION
Questions 51 - 54 only pertain to activity below the terminal rack.
51. Will you blend tax-paid fuel products with untaxed products?
Yes
No
52. Will you blend ethanol and gasoline to produce a gasoline product?
Yes
No
53. Will you blend biodiesel and petroleum diesel to produce a diesel product?
Yes
No
54. Will you add dye to biodiesel or a biodiesel/petroluem diesel blend?
Yes
No
PART 11: TRANSPORTER INFORMATION
55. Will you be hired to transport fuel into or out of the State of Michigan?
Yes
No
56. Indicate Method(s) of Transport
Truck
Rail
Other: ________________________________________________
IFTA Jurisdiction (if transporting by truck)
Account Number (if transporting by truck)
PART 12: RETAIL DIESEL WATERWAYS INFORMATION
57. Will you sell diesel fuel into fuel supply tanks of watercraft?
Yes
No
PART 13: LIQUEFIED PETROLEUM GAS (LPG) INFORMATION
Yes
No
58. Will you sell or use LPG for motor vehicles that use Michigan highways?
59. Will you have LPG storage from which both highway and non-highway fuel is disbursed?
Yes
No
60. Will 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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