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TOB: STTFC

8 / 0 4

OFFICE USE ONLY

L A B A M A

E PA RT M E N T O F

E V E N U E

, U

& B

A L E S

S E

U S I N E S S

A X

I V I S I O N

O B A C C O

A X

E C T I O N

P.O. B

327556 • M

, AL 36132-7556 • (334) 242-9627

O X

O N T G O M E R Y

Monthly Underg round and Abovegro u n d

Storage Tank Trust Fund Charg e

NAME

ADDRESS

C N : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

CITY

STATE

ZIP

(OFFICE USE ONLY)

Month of_____________________________________, _______

Check here if new address

Contact Person: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

F E I N / S S N :

Permit Number: C T

–

Phone Number: ( _ _ _ _ _ _ _ _ ) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

COLUMN A

COLUMN B

COLUMN C

OFFICE USE ONLY

Indicate Total Gallons Withdrawn from Bulk

Rate of Charge

Amount Due

and/or Total Gallons Imported from Out-of-State

(per gallon)

(Multiply Column A by Column B)

1 .

0 . 0 1

2 .

Late Filing Penalty (The greater of 10% of line 1 or $50) . . . . . . . . . . . . . . . . . . . . . . .

3 .

Late Payment Penalty (10% of line 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4 .

Interest (Contact the Department for rate) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5 .

Gross Amount Due (Add lines 1 through 4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6 .

Less Authorized Credit (Attach Letter). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7 .

Net Amount Due (Line 5 minus line 6). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8 .

Amount Remitted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Check here if payment is remitted through EFT

DO NOT TAKE CREDITS UNLESS GIVEN AUTHORIZATION

Under penalties of perjury, I hereby certify this return to be true and accurate.

Signature: _____________________________________________

Date: ________________________________________________

Title: ______________________________________________ _ _ _ _

ALL PREVIOUS FORMS ARE OBSOLETE AND SHOULD BE DESTROYED.

Mail this return to the address above with remittance payable to the Alabama Department of Revenue, on or before the 20th of each

month. Even if there is no activity during the month, a return must be filed and marked “No Activity”.

GENERAL INFORMATION

This report and payment of fees are to be submitted by operators of a motor fuels bulk facility located in Alabama from which a first

withdrawal from bulk is made and the owner of motor fuels which are delivered in Alabama that have been withdrawn from bulk outside of

this state.

When motor fuel is delivered inside of Alabama from outside of this state, the charge will apply at the point that the fuel is dropped inside

Alabama. The deliverer (importer) is the “owner” of the fuel and is responsible for collecting and remitting the charge.

E x e m p t i o n s

Any fuel oil withdrawn from bulk to be used in the generation of electricity is exempt from the charge.

Motor fuels withdrawn from bulk in which the ultimate destination is outside the state of Alabama are exempt from the charge.

Relevant Terms

“Motor fuels” are defined as, “All grades of gasoline including gasohol or any gasoline blend, number 1 diesel, number 2 diesel, kerosene

and all aviation fuels.” It is the Alabama Department of Revenue’s interpretation that number 1 and number 2 fuel oils are included in the

definition of motor fuels.

“Bulk facility” is defined as, “a facility, including pipeline terminals, refinery terminals, motor fuel distribution terminals, rail and barge

terminals, and associated tanks, connected or separate, from which motor fuels are withdrawn from bulk and delivered into a cargo tank

used to transport these materials.”

“Cargo tank” is defined as, “an assembly that is used for transporting, hauling, or delivering liquids and that consists of a tank having one

or more compartments mounted on a wagon, truck or trailer.”

“Withdrawal from bulk” is defined as, “the removal of motor fuel or a combination of motor fuels from bulk facility storage tanks directly

into a cargo tank to be transported to a location in this state. The underground and aboveground storage tank trust fund charge shall not

be assessed on motor fuel withdrawn from bulk the ultimate destination of which is outside the state of Alabama. Withdrawal of different

grades of motor fuel into separate compartments of a cargo tank does not constitute separate withdrawals from bulk.”

Form Tob: Sttfc - Monthly Underground And Aboveground Storage Tank Trust Fund Charge

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