Form Mft-504 - West Virginia Motor Fuel Supplier/permissive Supplier Page 2

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SECTION 1
SUPPLIER/PERMISSIVE SUPPLIER INFORMATION – Report in Whole Gallons
Line 1
By product type - Enter the Net Taxable Gallons from Worksheet A, Line 13;
NOTE: For propane, dyed motor fuel, aviation gasoline and aviation jet fuel, the taxable gallons are subject to the variable rate only.
Combined West Virginia Flat Rate and Variable Rate Tax
Line 2
Line 3
By product type - Multiply Line 1 by Line 2 - Enter amount of tax due
Line 4
By product type - Enter the Net Taxable Gallons from Worksheet A, Line 13
NOTE: For gasoline, gasohol, undyed diesel, clear kerosene, and other, the taxable gallons are subject to the combined rate.
West Virginia Variable Rate Tax
Line 5
Line 6
By product type - Multiply Line 4 by Line 5 - Enter amount of tax due
Line 7
Enter exempt fuel (gallons) sold for taxable purpose (on-highway) from Worksheet A, Line 2 and Line 4.
West Virginia Flat Rate Tax
Line 8
Line 9
By product type - Multiply Line 7 by Line 8 - Enter amount of tax due
Line 10
By product type - Add Line 6 plus Line 9 - Enter total amount of tax due
SECTION 2 - TAX CALCULATION
Line 1
Sum of Section 1 Line 3 and Line 10 for all Columns - Enter grand total amount of tax due and transfer to front of the report - Line 1
TOTAL TAX CALCULATION
Line 1
Enter amount from Section 2 Line 1
Line 2
Enter amount from Worksheet A Line 10
Line 3
Multiply Line 1 by 0.001-Enter amount of discount (Note: Take only if return is timely filed, maximum $5000.00)
Line 4
Gross amount due, Line 1 minus Line 2 and Line 3 - Enter gross amount due
Line 5
Enter total amount of tax owed by a licensed Distributor and/or licensed Importer that was previously claimed as a Default Deduction,
which has been paid. Also, enter the name of the Distributor and/or Importer, who remitted payment.
Line 6
Enter the amount of tax payments that a licensed Distributor and/or licensed Importer has failed to remit.
Note: To be eligible for this deduction, you must submit a Notice of Tax Payment Default (WV/MFT-512) within 10 business days from
the date required to file the tax report to the West Virginia State Tax Department.
Line 7
Total Amount Due, Line 4 plus Line 5 minus Line 6 - Enter total amount due
Line 8
Enter credit amount from previous month’s return. Also enter month and year for the period ended. (MM/YY)
Line 9
Enter credit amount from West Virginia Exporter Return (WV/MFT-511). Also enter month and year for period ended. (MM/YY)
Line 10 Total credits, sum Line 8 and Line 9 - Enter total credit due
Line 11 Net amount tax due, Line 7 minus Line 10 - Enter net amount of tax due (If Line 10 is greater than Line 7 - Enter 0)
Line 12 Non-Waivable Interest, multiply Line 11 by current interest rate - Enter total amount of interest
Line 13 Additions to Tax - Multiply Line 11 by 0.05 by the number of months late. If no tax due, a late filing penalty of $50 per month for each
month or part of a month after the due date must be remitted- Enter total amount of additions
Line 14 Total Tax and Late Filing Charges Due, sum Lines 11 through 13 - Enter total amount of tax, interest and penalties due
Line 15 Overpayment Amount, Line 10 minus Line 7 - Enter total amount of overpayment (If line 7 greater than Line 10-Enter 0)
Line 16 CREDIT - (To take credit on the next monthly return) - Enter amount from Line 15
Line 17 REFUND - (To obtain a refund) - Enter amount from Line 15
Note: Remember to sign your return and maintain a copy for your records.

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