Form Amft-22 (F) - Gasoline First Receiver
Download a blank fillable Form Amft-22 (F) - Gasoline First Receiver in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Amft-22 (F) - Gasoline First Receiver with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1AMFT-22 (F)
STATE OF ARKANSAS
REV - 5/97
DEPARTMENT OF FINANCE & ADMINISTRATION
MOTOR FUEL TAX SECTION
P. O. BOX 1752 LITTLE ROCK, AR 72203-1752
PHONE (501) 682-4800
GASOLINE FIRST RECEIVER
CHECK HERE IF FILING AMENDED REPORT
CHECK IF THIS IS A FINAL REPORT
NAME
ACCOUNT
NUMBER
0
0
0
0
P O BOX
FEIN
STREET
YEAR
MONTH
NUMERICAL
19
REPORT MONTH
PHONE NUMBER
CITY STATE AND ZIP
(
)
FOLLOW INSTRUCTIONS ON REVERSE SIDE OF THIS FORM IN PREPARING REPORT
1. GALLONS RECEIVED TAX PAID (FORM R SCHEDULE TYPE 1).............................................................
2. GALLONS RECEIVED IN ARKANSAS TAX UNPAID (FORM R SCHEDULE TYPE 2).....................................
3. GALLONS IMPORTED FROM ANOTHER STATE (FORM R SCHEDULE TYPE 3)........................................
4. TOTAL RECEIVED IN ARKANSAS (TOTAL LINES 1,2,& 3)....................................................................
5. FUEL SOLD OUT OF STATE (FORM D SCHEDULE TYPE 7)..................................................................
6. AVIATION GASOLINE (FORM D SCHEDULE TYPE 10B)......................................................................
7. SALES TO U S GOVERNMENT (FORM D SCHEDULE TYPE 8)................................................................
8. TAX PAID PURCHASES (FORM R SCHEDULE TYPE 1).........................................................................
9. CASUALTY LOSSES (FORM D SCHEDULE TYPE 10H)...........................................................................
10. BORDER ZONE (FORM D SCHEDULE TYPES 5I / 5J).........................................................................
11. TOTAL DEDUCTIONS (LINE 5 THRU 10).........................................................................................
12. ARKANSAS TAXABLE GALLONS (LINE 4 MINUS LINE 11)..................................................................
13. LESS 3% OF FIRST 1,000,000 GALLONS.......................................................................................
14. ARKANSAS TAXABLE GALLONS ( LINE 12 MINUS LINE 13)..............................................................
COMPUTATION OF TAX
15. AR GALLONS............
AR TAX DUE @ .185.................................
16. MO BZ GALLONS......
MO TAX DUE @ .18.................................
17. OK BZ GALLONS......
OK TAX DUE @ .17.................................
18. NET GALLONS.........
19. CREDIT FROM PRIOR MONTH (S) (OVER $ 1.00).........................................................................
20. TOTAL TAX REMITTED OR CREDIT (EFT TAX TYPE 05101)............................................................
I, The Undersigned, hereby declare under penalties of law that the information
provided above is true and correct to the best of my knowledge.
CREDIT______
SIGNATURE____________________________________________________________________
CHECK ONE :
REFUND______
DATE___________________________________________________________________________
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial