Form Rmft-32-Df - Schedule Dd - Mft, Ust, And Eif Dyed Diesel Fuel Sold And Distributed Tax- And Fee-Free In Illinois To Licensed Distributors Or Suppliers

Illinois Department of Revenue

MFT, UST, and EIF

Page ____ of ____

Schedule DD

Dyed Diesel Fuel Sold and Distributed

Tax- and Fee-Free in Illinois to Licensed Distributors or Suppliers

Attach to Form RMFT-5 or Form RMFT-5-US

Step 1: Complete the following information

_______________________________________________

Check the tax/fee type you are listing on this page.

Company name

MFT-free only

_______________________________________________

UST-/EIF-free only

Your license number

Reporting period __ __/__ __ __ __

Both MFT- and UST-/EIF-free

Month

Year

Step 2: Report your tax- and fee-free sales and distributions

Invoice date

Invoice

Name of

Bill of lading or

Origin

Destination

Purchaser’s

Invoiced

number

carrier

manifest number

Name of purchaser

(Illinois cities only)

license number

gallons

(month, day, year)

_ _/_ _/_ _ _ _ ______________ __________________ ___________________________________________________________________________________ _________________

9 _ _/_ _/_ _ _ _ ______________ __________________ ___________________________________________________________________________________ _________________

_ _/_ _/_ _ _ _ ______________ __________________ ____________________________________________________________________________________________________

11 Add the invoiced gallons in Column 9, Lines 1 through 10, and write the total here.

_________________

12 If you are filing only one Schedule DD, write the amount from Line 11 here.

_________________

If you are reporting

• MFT-free gallons only, also write this amount on Form RMFT-5, Line 8a, Column 3.

• UST-/EIF-free gallons only, also write this amount on Form RMFT-5-US, Line 8, Column 1.

• both MFT- and UST-/EIF-free gallons, also write this amount on Forms RMFT-5, Line 8a, Column 3, and RMFT-5-US, Line 8, Column 1.

If you are filing more than one Schedule DD, see instructions.

This form is authorized as outlined by the Motor Fuel Tax Law and the Environmental Impact Fee Law. Disclosure of this information is REQUIRED.

RMFT-32-DF front (N-12/99)

Failure to provide information could result in a penalty. This form has been approved by the Forms Management Center.