Instructions For Form 4136 - Credit For Federal Tax Paid On Fuels

Lines 7a and 7b. Sales by Registered Ultimate

Allowable uses. For lines 5a and 5b, the kerosene

must have been used during the period of claim in

Vendors of Undyed Kerosene (Other Than

noncommercial aviation. If the claimant buys kerosene

Kerosene for Use in Aviation)

partly for use in commercial aviation and partly for use in

Claimant. For line 7a, the registered ultimate vendor of

noncommercial aviation, see the rules in Notice 2005-80,

the kerosene is the only person eligible to make this

section 3(e)(3).

claim and has obtained the required certificate from the

buyer and has no reason to believe any information in the

For lines 5c and 5d, the kerosene must have been

certificate is false. See Model Certificate P in Pub. 510.

used during the period of claim for types of use 1, 9, 10,

For line 7b, claimant has a statement, if required, that

11, 13, 15, or 16.

contains the date of sale, name and address of the

For line 5e, the kerosene must have been used during

buyer, and the number of gallons of kerosene sold to the

the period of claim for type of use 9. This claim is made

buyer. For lines 7a and 7b, only one claim may be filed

in addition to the claim made on lines 5c and 5d for type

for any gallon of kerosene.

of use 9.

Allowable sales. The fuel must have been sold during

the period of claim:

Information for Claims on Lines 6–8

•

For line 7a, use by a state or local government

Registration number. To make an ultimate vendor

(including essential government use by an Indian tribal

claim on lines 6–8 you must be registered. Enter your

government), or

•

registration number, including the prefix, on the

For line 7b, from a blocked pump.

applicable line for your claim. If you are not registered,

Registration number. Enter your UV or UP registration

use Form 637, Application for Registration (For Certain

number in the space provided.

Excise Tax Activities), to register.

Information to be submitted. For claims on line 7a,

Required certificates or waiver. The required

attach a separate sheet with the name and TIN of each

certificates or waivers for lines 6–8 are listed in the line

governmental unit to whom the kerosene was sold and

instructions and are available in Pub. 510.

the number of gallons sold to each.

Line 7c. Sales by Registered Ultimate Vendors

Line 6a. Sales by Registered Ultimate Vendors

of Undyed Kerosene for Use in Certain Intercity

of Undyed Diesel Fuel

and Local Buses

Claimant. For line 6a, the registered ultimate vendor of

Claimant. For line 7c, the registered ultimate vendor of

the diesel fuel is the only person eligible to make this

the kerosene is eligible to make a claim only if the buyer

claim and has obtained the required certificate from the

buyer and has no reason to believe any information in the

waives his or her right to make the claim by providing the

registered ultimate vendor with an unexpired waiver. See

certificate is false. See Model Certificate P in Pub. 510.

Model Waiver N in Pub. 510. Only one claim may be filed

Only one claim may be filed for any gallon of diesel fuel.

for any gallon of kerosene.

Allowable sales. The fuel must have been sold during

Registration number. Enter your UB registration

the period of claim for the exclusive use by a state or

number in the space provided.

local government (including essential government use by

an Indian tribal government).

Lines 8a and 8b. Sales By Registered Ultimate

Vendors of Kerosene For Use in Commercial

Registration number. Enter your UV registration

Aviation (Other Than Foreign Trade)

number in the space provided.

Information to be submitted. For claims on line 6a,

The credit rate for line 8a may change after March

attach a separate sheet with the name and TIN of each

31, 2011.

governmental unit to whom the diesel fuel was sold and

CAUTION

the number of gallons sold to each.

Claimant. The registered ultimate vendor of the

kerosene sold for use in commercial aviation is eligible to

Line 6b. Sales by Registered Ultimate Vendors

make this claim only if the buyer waives his or her right

of Undyed Diesel Fuel for Use in Certain

by providing the registered ultimate vendor with an

Intercity and Local Buses

unexpired waiver. See Model Waiver L in Pub. 510. Only

one claim may be filed for any gallon of kerosene sold for

Claimant. For line 6b, the registered ultimate vendor of

use in commercial aviation.

the diesel fuel is eligible to make a claim only if the buyer

waives his or her right to make the claim by providing the

Allowable sales. The kerosene sold for use in

registered ultimate vendor with an unexpired waiver. See

commercial aviation must have been sold during the

Model Waiver N in Pub. 510. Only one claim may be filed

period of claim for use in commercial aviation (other than

for any gallon of diesel fuel.

foreign trade).

Registration number. Enter your UB registration

Registration number. Enter your UA registration

number in the space provided.

-4-

Instructions for Form 4136 (2010)

Instructions For Form 4136 - Credit For Federal Tax Paid On Fuels - 2010 Page 4

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