Form Epcq - Protection Charge Quarterly Return - Iowa Department Of Revenue
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1IOWA DEPARTMENT OF REVENUE ENVIRONMENTAL
Iowa Department of Revenue
PROTECTION CHARGE QUARTERLY RETURN
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INSTRUCTIONS
5. PENALTY FOR FAILURE TO TIMELY FILE A
Enter the total petroleum gallons
1. TOTAL GALLONS:
RETURN or DEPOSIT: A penalty of 10 percent will be
placed intoall storage tanks for the entire quarter.
added to the charge due for failure to timely file a return
or deposit if at least 90 percent of the correct amount of
2. EXEMPT GALLONS and GALLONS QUALIFYING
tax is not paid by the due date. The penalty can only be
FOR CREDIT: Failure to itemize will result in
waived under limited circumstances.
disallowance of all gallons shown on line 2 of this form.
PENALTY FOR FAILURE TO TIMELY PAY THE
CHARGE DUE or PENALTY FOR AUDIT DEFICIENCY:
a.
EXEMPT GALLONS: Enter the petroleum gallons
A penalty of 5 percent will be added to the tax due if at
pumped into exempt storage tanks for the entire quarter.
least 90 percent of the correct amount of the charge is
These amounts must be included in line 1.
not paid by the due date. The penalty can only be waived
under limited circumstances.
b. GALLONS QUALIFYING FOR CREDIT: Enter the
petroleum gallons for the quarter which qualify for credit
If more than one penalty applies, the 10% penalty is the
only one charged.
under Iowa Code Section 424.6(1).
6. INTEREST: Interest accrues on the unpaid portion of
charge from the due date on the return. Any fraction of a
a. EXEMPT GALLONS
month is considered a whole month for purposes of
computing interest. Interest can never be waived. Check
b. GALLONS QUALIFYING FOR CREDIT
our Web site for interest rates at .
TOTAL (add lines a and b, enter on line 2)
Make check payable to: Treasurer, State of Iowa.
Mail to: Iowa Department of Revenue
PO Box 10455
Des Moines IA 50306-0455
EPCQ
If no gallons to report, put put zeroes on lines 1 and 7.
IOWA DEPARTMENT OF REVENUE
1. TOTAL GALLONS
ENVIRONMENTAL PROTECTION CHARGE
L
QUARTERLY RETURN
2. EXEMPT GALLONS AND GALLONS
87-002 11/28/12
QUALIFYING FOR CREDIT (over)
L
3. GALLONS SUBJECT TO CHARGE
Subtract line 2 from line 1
4. CHARGE DUE. 1 cent per gallon
$
Multiply line 3 by $0.01.
L
Date Due
Permit No.
For Quarter Ending
L
$
5. PENALTY
L
$
6. INTEREST
L
7. TOTAL AMOUNT DUE
$
Add lines 4, 5, and 6
L
When you pay by check, you authorize the Department of Revenue to convert your check to a
one-time electronic banking transaction.
Date
Title
Signature
*1287002019999*
Check box if this is your final return and give the last date
______________
of gallons subject to EPC charge:__________________
Phone:
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