Motor Fuel Distributor Report printable pdf download

Motor Fuel Distributor Report

STATE OF WEST VIRGINIA

State Tax Department, Tax Account Administration Div

P.O. Box 2991

Charleston, WV 25330-2991

Craig A. Griffith, Tax Commissioner

Earl Ray Tomblin, Governor

Name

Address

Account #:

City

State

Zip

WV/MFT-501

WEST VIRGINIA MOTOR FUEL DISTRIBUTOR REPORT

rtL152 v.3 - Web

NOTE: This return has been redesigned. To avoid delays in the processing of this return, DO NOT use any older

forms you may have. For information regarding the State Tax Department’s new computer system, visit our

website at

This report is not required if no reportable activity. Reports with activity must be postmarked by the last

day of the month following report month.

Period Ending:

Due Date:

FINAL

AMENDED

SECTION 1 - DISTRIBUTOR INFORMATION

Report in whole gallons

Gasoline

Gasohol

Undyed Diesel

Clear Kerosene / Other

Total Gallons Tax Unpaid

(Sch 2)

Combined Rate

0.3220

Tax Due

(Line 1 times Line 2)

Report in whole gallons

Dyed Diesel and Kerosene

Propane

Aviation Gasoline

Aviation Jet Fuel

Total Gallons Tax Unpaid

At Variable Rate (Sch 2)

Variable Rate

0.1170

Tax Due - Variable Rate

(Line 4 times Line 5)

Flat Rate exempt fuel sold

for taxable use (Sch 5X)

Flat Rate

0.2050

Tax Due - Exempt Fuel

(Line 7 times Line 8)

Tax Due

10.

(Line 6 plus Line 9)

SECTION 2 - TOTAL TAX DUE

BALANCE OF TAX DUE (Sum of Section 1 Line 3 and Line 10 all columns)

NON-WAIVABLE INTEREST

ADDITIONS TO TAX (5% per month, not to exceed 25%; if no tax due $50 per month)

TOTAL TAX AND LATE FILING CHARGES DUE (Add Lines 1 through 3)

MAIL TO: WEST VIRGINIA STATE TAX DEPARTMENT

Tax Account Administration Div

P.O. Box 2991, Charleston, WV 25330-2991

FOR ASSISTANCE CALL (304) 558-3333 TOLL FREE (800) 982-8297

For more information visit our web site at:

File online at https://mytaxes.wvtax.gov

Motor Fuel Distributor Report

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