Dor/dmv Form 592 - Ethanol Producer Return - 2009 Page 4
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5Mail
Remittance Center
Ethanol Producer Return
Return to:
P.O. Box 5055
Sioux Falls, SD 57117-5055
Check here if this is an amended report
Report in Whole Gross Gallons Only
DENATURED FUEL-GRADE ALCOHOL INVENTORY & SALES
1
1
Total gallons of fuel-grade alcohol in producer's inventory at beginning of reporting period
2
2
Total gallons of fuel-grade alcohol produced or upgraded during reporting period
3
3
Subtotal gallons of fuel-grade alcohol -- Add Lines 1 and 2
Total gallons of fuel-grade alcohol sold to licensed suppliers for resale at a terminal and licensed exporters for export during reporting
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4
period -- Attach Uniform Schedule of Disbursements - Type 6a or 6d
Total gallons of taxable fuel-grade alcohol sold to parties other than licensed suppliers for resale at a terminal and unlicensed exporters
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5
for export during reporting period -- Attach Uniform Schedule of Disbursements - Type 5
6
6
Total gallons of fuel-grade alcohol sold during reporting period -- Add Lines 4 and 5
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7
Total gallons of fuel-grade alcohol remaining in inventory at end of reporting period -- Subtract Line 6 from Line 3
ETHANOL PRODUCTION INCENTIVE
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8
Total gallons fuel-grade alcohol sold during reporting period -- Record amount from Line 6 here
9
9
Total gallons fuel-grade alcohol produced out-of-state
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10
Net gallons eligible for production payment -- Subtract Line 9 from Line 8
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$0.20
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Production Payment Rate
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12
Production payment allowance for this reporting period -- Multiply Line 10 by Rate on Line 11
TAXES AND FEES DUE
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13
Allowance (If filing on time) -- Multiply Line 5 by 0.0225
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14
Fuel Tax Due -- Subtract Line 13 from Line 5 and multiply by $0.08
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15
Tank Inspection Fee -- Multiply Line 5 by $0.02
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16
Total gallons of natural gasoline used for denaturing alcohol -- Determine this from your records
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17
Total gallons of gasoline used for denaturing alcohol -- Determine this from your records
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18
Net Credit Due for gallons of gasoline and/or natural gasoline used as a denaturant -- Multiply Lines 16 & 17 by $0.22 tax rate
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19
Tank Inspection Fee -- Multiply Lines 16 & 17 by $0.02
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20
Total credit for this reporting period -- Add Lines 18 and 19
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Total taxes and fees for this reporting period -- Add Lines 14, 15 and subtract Line 20
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22
Interest and or Penalty
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23
Balance Due or Credit from prior records (See Computer Notice)
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24
Total payment due for this reporting period - Add Lines 21, 22 and add or subtract Line 23 (Depending on balance due or credit)
SIGNATURE
I, ____________________________________ , for the ethanol producer name on the front of this report, do hereby certify under penalty of perjury that I have examined
this claim, and, to the best of my knowledge and belief, it is correct and complete. I further certify that all ethanol has been produced from agricultural products at a
refinery facility located within South Dakota and that such ethanol has been denatured and meets the 99% purity requirement.
Signature
Title
Date
DOR/DMV FORM 592(7/09)
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