User Claim for Refund
column that corresponds to tax rate paid when you
purchased the fuel. Enter a negative number in the
Use this form to claim a refund for fuel used:
column that corresponds to the tax rate applicable to
(1) for exempt purposes;
the use of the fuel.
(2) in non-licensed vehicles (non-highway use); or
(3) at a rate that was less than the rate paid when
See below for an example of how to complete a
the fuel was purchased (fuel conversion).
conversion refund request.
Note: You may not claim a non-highway refund for
fuel used in a licensed vehicle even though the
vehicle was not used on a public way.
AS 43.40.030 authorizes a refund of 6¢ per gallon for
highway fuel not used in or in conjuction with a motor
Original purchase invoices must accompany this
vehicle licensed to be operated on public ways. A 3¢
User Claim for Refund.
per gallon refund may be claimed for marine fuel used
in non-licensed off-road vehicles.
If this is an amended claim, please write
AMENDED at the top of the form.
On line 16, enter the number of gallons for which you
are claiming a non-highway refund.
Exempt Fuel Use
If the use of fuel qualifies for an exemption from
motor fuel tax, you may claim a refund for the total
Use Schedule of Jet Fuel Used in Foreign
tax paid on the fuel.
Flights (Air Carriers Only) for flights going
Lines 1 through 6
directly to a foreign country (without intermediate
stops within the United States) or continuing from a
Indicate the gallons of fuel for which you are
claiming a refund. Note: supporting schedules are
required for exemptions checked with a Τ.
Τ Use Schedule of Non-Highway Motor Fuel
Use to claim a refund for fuel used in equipment
Complete this section to claim a refund on fuel used
(including non-licensed vehicles).
at a rate that was different from the rate paid when
you purchased the fuel.
You are required to use the Schedule of Invoices only if
there are more than 10 purchase invoices accompanying
Enter the number of gallons for which you are
this refund claim.
claiming a refund as a positive number in the
Need Help? Contact us at (907) 465-4661; or e-mail us at: firstname.lastname@example.org
Conversion Example: If you purchased 'tax-on' highway gasoline and used it for marine purposes, you
would fill in the form as shown below. The total marine tax is subtracted from the fuel tax paid, which results in
a $300 refund.
Fuel Conversions (to a lower tax rate only)
Highway to marine
Gasohol hwy to marine
15. Total conversion refund
Form 04-544 Back (Revised 6/97)