Form Mf-2 - Licensed Dealer'S Monthly Ohio Motor Fuel Tax Report
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1MF-2
Rev. 9/00
LICENSED DEALER’S MONTHLY OHIO MOTOR FUEL TAX REPORT
__________________________________
_________________
_______________
DEALER NAME
FEIN
MONTH/YEAR
_________________________________
_____________________
________
_____________
STREET
CITY
STATE
ZIP
Check here to cancel account _____ Effective __________________
Check here if address is new ____
TRANSFER TOTALS FROM FUEL SCHEDULES
1.) Gasoline (
)
1.)
Schedule MF-2A line 9
2.) Dyed Low Sulfur Diesel (
)
2.)
Schedule MF-2B line 13
3.) Kerosene (
)
3.)
Schedule MF-2C line 16
4.) Clear Diesel (
)
4.)
Schedule MF-2D line 15
5.) This line intentionally left blank.
5.)
6.) Miscellaneous Fuels (
)
6.)
Schedule MF-2F line 8
7.) Gross Taxable Gallons (
)
7.)
add lines 1 through 6
8.) Shrinkage (
)
8.)
if filed timely, multiply line 7 by 3%
9.) Retail Shrinkage (
)
9.)
add 1% of gallons sold to retailers
10.) Net Taxable Gallons (
)
10.)
line 7 plus line 9 minus line 8
11.) Gross Tax (
)
11.) $
multiply line 10 by $0.22
12.) This line intentionally left blank.
12.)
13.) This line intentionally left blank.
13.)
14.) Tax Due (
)
14.) $
line 11
15.) Late Filing Charge
15.) $
16.) Interest
16.) $
17.) Total Amount Due (
)
17.) $
lines 14, 15 & 16
I declare under penalties of perjury that this report (including any accompanying schedules and statements) has been
examined by me and to the best of my knowledge and belief is a true, correct, and complete report.
_____________________________________ ____________________________ __________________ ___________
(Authorized Signature)
(Title)
(Telephone Number)
(Date)
This report must be filed with the Treasurer of State, P.O. Box 87, Columbus, Ohio 43266-0087 and received by the last
day of each month following the report period. Telephone inquiries (614) 466-3503; Fax (614) 752-8644
(Over)
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