Form Tc-922 - Ifta/special Fuel User Tax Return - 2017
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1
2Clear form
Utah State Tax Commission
92281
TC-922
IFTA/Special Fuel
Rev. 3/17
User Tax Return
Check box if filing Special
Check box if this
9998
is an
AMENDED
return
Fuel User return only
2. Due date (mmddyyyy)
1. Tax period (mmddyyyy)
Name and address
3a. IFTA/SFU Account number
UT-
3b. Federal ID (FEIN/EIN)
4. Fuel Summary (for qualified vehicles) (round to nearest whole gallons/miles)
(a)
(b)
(c)
(d)
Fuel
Total miles
Total gallons
Average fleet
type
traveled for all
used for all
MPG (2 decimal
jurisdictions
jurisdictions
places)
D-Diesel
IFTA
UF-Special
Fuel User
Other:
Check box to stop receiving paper forms
Totals
5. IFTA Fuel Tax and Utah Special Fuel Tax (round to nearest whole gallons and miles)
For current IFTA tax rates and updates, go to
j
a
b
c
d
e
g
h
i
k
f
Interest
Juris-
Total miles
Taxable miles
Net taxable
Total
Fuel type
Tax rate
Taxable
Fuel
Tax
due
due or (credit)
diction
in
in
gallons
See back
gallons
tax-paid
due or (credit)
Jurisdictions
(f minus g)
Jurisdictions
(see instruc)
gallons
(i plus j)
Non-IFTA jurisdictions are Washington DC, Hawaii, Alaska, Yukon,
Miles for all Non-IFTA
6.
Northwest Territories, Mexico, etc. List Oregon in section 5 above.
Jurisdictions
TOTAL all pages
7.
(columns d thru k)
Utah sales tax due
8.
9.
Check box if NO OPERATION
Attach TC-922A
Credit for tax reported on
(
)
10.
CANCEL IFTA License
(Cancel date: _______________)
exempt fuel-Attach TC-922B
(mm/dd/yyyy)
Previous payments or refunds
11.
Check box if
ADDRESS CORRECTION
needed
(for amended returns only)
12.
Penalty (see instructions)
Mail to: Utah State Tax Commission
210 N 1950 W
13.
Balance due or Refund
Salt Lake City, Utah 84134-0520
I certify under penalties of perjury, this return is true, correct, and complete to the best of my knowledge.
Signature (required)
Title
Date
Telephone
For office use only
_________________
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