Form Mf-360 - Consolidated Gasoline Monthly Tax Return
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5Indiana Department of Revenue
Form
Consolidated Gasoline Monthly Tax Return
MF-360
State Form 49276
Due date is the 20th of the following month.
(R5 / 5-17)
For the month of:_________________ 20_____
Name of License Holder (as indicated on license)
License Number (as indicated on license)
Mailing Address
FEIN/SSN
City
State
ZIP Code
Business Phone Number Contact Name
Section 1: Filing Types
This is a consolidated return for all license types listed below. Place an “X” in the box to the left of each license type for which you are
licensed.
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Gasoline
Oil Inspection Distributor
Gasohol Blender
Section 2: Calculation of Gasoline Taxes Due
1 Total receipts (From Section A, Line 8, Column D)
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2 Total non-taxable disbursements (From Section B, Line 10, Column D)
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3 Gallons received, gasoline tax paid (From Section A, Line 1, Column A)
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4 Billed taxable gallons (Line 1 minus Line 2 minus Line 3)
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5 Licensed gasoline distributor deduction (Multiply Line 4 by 0.016)
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6 Billed taxable gallons (Line 4 minus Line 5)
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7 Gasoline tax due (Multiply Line 6 by the applicable rate, see instructions)
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8 Adjustments ( Schedule E-1 must be attached and is subject to department approval)
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9 Total gasoline tax due (Line 7 plus or minus Line 8)
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Section 3: Calculation of Oil Inspection Fees Due
1 Total receipts (From Section A, Line 9, Column D)
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2 Total non-taxable disbursements (From Section B, Line 11, Column D)
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3 Gallons received, oil inspection fee paid (From Section A, Line 1, Column D)
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4 Billed taxable gallons (Line 1 minus Line 2 minus Line 3)
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5 Oil inspection fees due (Multiply Line 4 by $0.01)
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6 Adjustments (Schedule E-1 must be attached and is subject to department approval)
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7 Total oil inspection fees due (Line 5 plus or minus Line 6)
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Section 4: Calculation of Total Amount Due
1 Total amount due (Section 2, Line 9 plus Section 3, Line 7)
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2 Penalty (Penalty must be added if report is filed after the due date. 10% of tax due or $5.00,
whichever is greater.)
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3 Interest (Interest must be added if report is filed after the due date.)
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4 Net tax due (Line 1 plus Line 2 plus Line 3)
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5 Payment(s)
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6 Balance due (Line 4 minus Line 5)
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7 Gallons of gasoline sold to taxable marina
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