Form Mf-007 - Licensed Alternate Fuels Dealer Or User Report - 2012
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1MF-007: Licensed Alternate Fuels
Dealer or User Report
Period End Date (MM DD YYYY)
Use BLACK INK Only
Legal Name
Tax Account Number
Business Name (DBA)
FEIN / SSN
Permit/Business Address
City
State
Zip Code
/
/
Cancel my permit effective
Check if this is an amended return
(MM DD YYYY)
Check if address, name, or entity change
Check if correspondence is included
SUBMIT REPORT EVEN IF NO TAXES ARE DUE
(a)
(c)
(d)
(b)
Fuel Type
Tax Rate Per Gallon
Tax Due
Taxable Gallons
(column b x c)
1. CNG (compressed natural gas)
.247
$
2. LNG (liquefied natural gas)
.197
$
3. LPG (liquefied propane gas)
.226
$
4. Other Describe:
.309
$
5. TOTAL ALTERNATE FUEL TAX DUE
$
(add column d lines 1-4)
DECLARATION
I declare under penalties of law that the above information is true, correct, and complete to the best of my knowledge and belief.
Signature
Contact Person (please print clearly)
Telephone Number
Date
(
)
Wisconsin Deparatment of Revenue
MF-007 (R. 6-12)
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Parent category: Financial