Motor Fuels Tax Reimbursement Claim Form For Undyed Diesel And Undyed Kerosene Used In Truck Refrigeration Units (Page 2 of 2) in pdf

INSTRUCTIONS FOR COMPLETING THE PENNSYLVANIA MOTOR FUELS TAX

REIMBURSEMENT CLAIM FORM FOR UNDYED DIESEL AND UNDYED KEROSENE

USED EXCLUSIVELY IN TRUCK REFRIGERATION UNITS

Section 9017(e.1) of the Liquid Fuels and Fuels Tax Act,

Question 7 – Provide the number of truck refrigeration units

provides for a reimbursement of motor fuel taxes paid on

included in the claim.

undyed diesel and undyed kerosene used in truck refrigeration

Question 8 – Provide the year and quarter for which

units. To be eligible for the reimbursement: (1) individual fuel

reimbursement is requested.

purchases and invoices must be in quantities of 75 gallons

or less for each fueling; (2) the fuel must be placed into a

Question 9 – Provide your PA Sales/Use Tax License

Number. Indicate N/A if no license exists.

separate supply tank connected only to a truck- mounted

refrigeration unit (fuel placed into the tank used to supply fuel

Section B.

for the vehicle's engine is not eligible for reimbursement); (3)

Question 1 – Provide the number of gallons of undyed diesel

carriers must submit reimbursement claims postmarked on

or before the 60th day following the end of each calendar

or undyed kerosene used exclusively in truck refrigeration

units by month. NOTE: Carriers must submit copies of source

quarter; and (4) carriers must maintain records relative to

such fuel purchases for three years following the submission

documentation (fuel purchase invoices) for one month of the

claim or as otherwise directed by the department.

of a claim. Fuel purchase documentation such as invoices

must show the vendor's name and address, date of purchase,

Question 2 – Provide the total gallons claimed for the quarter

type of fuel, gallons purchased, total cost, vehicle unit

for which reimbursement is requested.

number, the purchaser's name and verification the fuel was

reefer fuel. In cases where fuel is dispensed from the carrier's

Question 3 – Calculate the reimbursement using the rate

table below.

own bulk storage into a supply tank used exclusively for truck

refrigeration, the carrier must maintain records similar to the

REIMBURSEMENT RATE TABLE

above to substantiate that the bulk-fuel purchases were

Use this table to calculate your reimbursement in Section B,

used in truck refrigeration and that tax was paid on the fuel

Line 3 on the front of this form.

purchased in PA for which tax reimbursement is sought.

YEAR

TAX RATE/GALLON

The department may require a claimant to satisfy any

sales/use tax liability on the undyed diesel/kerosene for which

2007

. . . . . . . . . . . . . . . . . . . . . . . . . . . .

$ 0.381

the reimbursement is claimed. Use tax is the 6 percent tax on

2008

. . . . . . . . . . . . . . . . . . . . . . . . . . . .

$ 0.381

the

use

tangible

personal

property

(undyed

2009

. . . . . . . . . . . . . . . . . . . . . . . . . . . .

$ 0.381

diesel/kerosene) or services when sales tax was not paid. An

2010

. . . . . . . . . . . . . . . . . . . . . . . . . . . .

$ 0.381

additional 1 percent local use tax applies to undyed

2011

. . . . . . . . . . . . . . . . . . . . . . . . . . . .

$ 0.381

diesel/kerosene purchased in Allegheny County; 2 percent

2012

. . . . . . . . . . . . . . . . . . . . . . . . . . . .

$ 0.381

local tax applies to undyed diesel/kerosene purchased in

2013

. . . . . . . . . . . . . . . . . . . . . . . . . . . .

$ 0.381

Philadelphia on or after Oct. 8, 2009. Prior to Oct. 8, 2009,

the Philadelphia local tax was 1 percent. Use tax should be

Section C.

calculated on the net purchase price (purchase price less tax

Sign the certification verifying the claimant did not directly

received as a refund) of the gallons for which a carrier has

or indirectly receive a refund or credit of the tax for which

received a refund and then remitted to the commonwealth

reimbursement is claimed, and the claim is true, complete

electronically via e-TIDES or TeleFile, unless the carrier’s use

and correct. Claim forms must be postmarked as described in

of the fuel qualifies for a sales/use tax business exemption.

the first paragraph to the left. Submit claims to:

Questions

regarding

sales/use

tax

undyed

diesel/kerosene should be directed to 717-787-1382.

PA Dept. of Revenue,

Bureau of Motor and Alternative Fuel Taxes

Records as described above must be maintained for a period

PO Box 280646, Harrisburg, PA 17128-0646.

of three years following the submission of a reimbursement

claim. Carriers failing to maintain records as described above

DO NOT SUBMIT THE CLAIM WITH YOUR QUARTERLY

may have reimbursement claims denied, and in the event a

IFTA TAX REPORT/SCHEDULE. Claims filed late

claim has already been paid, the refund may be assessed as

will be denied. Any claim denied may be appealed to

a chargeback.

the Department of Revenue, Board of Appeals at

or , PO Box 281021,

False claims, upon prosecution, are misdemeanors of the third

Harrisburg, PA 17128-1021.

degree pursuant to Section 9018 of the Liquid Fuels and Fuels

Tax Act.

A petition must be filed within 90 days of the date the claim

was denied.

LINE INSTRUCTIONS

Questions regarding truck refrigeration reimbursements

Section A.

should be directed to the Bureau of Motor and Alternative

Questions 1 through 6 – Provide the general information

Fuel Taxes at the address on the front of this form, or

requested about the claimant.

by calling 1-800-482-4382.

Motor Fuels Tax Reimbursement Claim Form For Undyed Diesel And Undyed Kerosene Used In Truck Refrigeration Units Page 2

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