Schedule 1
Department of the Treasury—Internal Revenue Service
(Form 8849)
Nontaxable Use of Fuels
OMB No. 1545-1420
(Rev. January 2002)
Attach to Form 8849.
Name as shown on Form 8849
EIN or SSN
Total refund (see instructions)
$
Period of claim: Enter month, day, and year
From
To
in MMDDYYYY for mat.
(b) Rate
(c) Gallons
(d) Amount of refund
(e)
(a)
1
Nontaxable Use of
CRN
Type
Gasoline and Gasohol
of use
Multiply col. (b) by col. (c)
$
.184
$
a
Gasoline
362
.184
b
10% gasohol
.131
359
c
7.7% gasohol
.14319
375
d
5.7% gasohol
.15379
376
2
Nontaxable Use of Aviation Gasoline
a
Use in commercial aviation
354
.15
$
$
(other than foreign trade)
.194
b
Other nontaxable use
324
.194
3
Nontaxable Use of Undyed Diesel Fuel
Claimant has the name and address of the person(s) who sold the diesel fuel to the claimant and the date(s) of the
purchase(s) and if exported, the required proof of export.
Claimant certifies that the diesel fuel did not contain visible evidence of dye.
Exception. If any of the diesel fuel included in this claim did contain visible evidence of dye, attach a detailed explanation
and check here
Caution: Claims cannot be made on line 3 for diesel fuel used on a farm for farming purposes or for the exclusive use by a
state or local gover nment. Only registered ultimate vendors may make those claims using Schedule 2.
(b) Rate
(c) Gallons
(d) Amount of refund
(e)
(a)
CRN
Type
of use
Multiply col. (b) by col. (c)
$
.244
$
a
Nontaxable use (see Caution
360
above)
.244
b
Use in trains
353
.20
c
Use in certain intercity
.17
350
and local buses
4
Nontaxable Use of Undyed Kerosene
Claimant has the name and address of the person(s) who sold the kerosene to the claimant and the date(s) of the
purchase(s) and if exported, the required proof of export.
Claimant certifies that the kerosene did not contain visible evidence of dye.
Exception. If any of the kerosene included in this claim did contain visible evidence of dye, attach a detailed explanation
and check here
Caution: Claims cannot be made on line 4 for kerosene used on a farm for farming purposes or for the exclusive use by a state or
local government, or for sales from a blocked pump. Only registered ultimate vendors may make those claims using Schedule 2.
(b) Rate
(c) Gallons
(d) Amount of refund
(e)
(a)
CRN
Type
of use
Multiply col. (b) by col. (c)
$
.244
$
a
Nontaxable use (see Caution
346
above)
.244
b
Use in trains
.20
348
c
Use in certain intercity
.17
347
and local buses
5
Nontaxable Use of Aviation Fuel
a
Use in commercial aviation
355
.175
$
$
(other than foreign trade)
b
Other nontaxable use
.219
369
c
Other nontaxable use
.044
377
6
Use of LPG in Certain Buses
a
Use in certain intercity and local
352
.062
$
$
buses
Use in qualified local buses
.136
b
361
Use in school buses
.136
For Privacy Act and Paperwork Reduction Act Notice, see Form 8849 instructions.
Cat. No. 27449T
Schedule 1 (Form 8849) (Rev. 1-2002)