Schedule 1 (Form 8849) - Nontaxable Use Of Fuels
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4Schedule 1
Nontaxable Use of Fuels
(Form 8849)
OMB No. 1545-1420
(Rev. January 2009)
Attach to Form 8849.
Department of the Treasury
See instructions.
Internal Revenue Service
Name as shown on Form 8849
EIN or SSN
Total refund (see instructions)
$
Caution. Claimant has the name and address of the person who sold the fuel to the claimant and the dates of purchase. For
claims on lines 1a and 2b (type of use 13 and 14), 3d, 4c, and 5, claimant has not waived the right to make the claim. For claims
on lines 1a and 2b (types of use 13 and 14), claimant certifies that a certificate has not been provided to the credit card issuer.
Period of claim: Enter month, day, and year
From
To
in MMDDYYYY format.
1 Nontaxable Use of Gasoline
(d) Amount of refund
(e)
(a) Type
(c) Gallons
(b) Rate
of use
CRN
Multiply col. (b) by col. (c)
a
Gasoline (see Caution above line 1)
362
$
.183
$
b Exported
.184
411
2
Nontaxable Use of Aviation Gasoline
a
Use in commercial aviation
354
(other than foreign trade)
$
.15
$
b
Other nontaxable use (see Caution above line 1)
324
.193
c
Exported
412
.194
d
LUST tax on aviation fuels used in foreign trade
433
.001
3
Nontaxable Use of Undyed Diesel Fuel
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
(d) Amount of refund
(e)
(a) Type
(c) Gallons
(b) Rate
of use
CRN
Multiply col. (b) by col. (c)
a
Nontaxable use
$
.243
360
$
b
Use on a farm for farming purposes
.243
c
Use in trains
353
.243
d
Use in certain intercity and local buses
(see Caution above line 1)
350
.17
e
Exported
413
.244
4
Nontaxable Use of Undyed Kerosene (Other Than Kerosene Used in Aviation)
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 sales from a blocked pump. Only registered ultimate vendors may
make those claims using Schedule 2.
(d) Amount of refund
(e)
(a) Type
(b) Rate
(c) Gallons
CRN
of use
Multiply col. (b) by col. (c)
a
Nontaxable use taxed at $.244
.243
$
346
b
Use on a farm for farming purposes
$
.243
c
Use in certain intercity and local buses
(see Caution above line 1)
.17
347
Exported
d
.244
414
e
Nontaxable use taxed at $.044
377
.043
Nontaxable use taxed at $.219
f
.218
369
5
Kerosene Used in Aviation (see Caution above line 1)
(d) Amount of refund
(e)
(a) Type
(b) Rate
(c) Gallons
CRN
Multiply col. (b) by col. (c)
of use
a
Kerosene used in commercial aviation
.200
$
417
(other than foreign trade) taxed at $.244
b
Kerosene used in commercial aviation
(other than foreign trade) taxed at $.219
.175
355
c
Nontaxable use (other than use by state or
346
local government) taxed at $.244
.243
d
Nontaxable use (other than by state or local
369
government) taxed at $.219
.218
e
LUST tax on aviation fuels used in foreign trade
433
.001
For Privacy Act and Paperwork Reduction Act Notice, see Form 8849 instructions.
Cat. No. 27449T
Schedule 1 (Form 8849) (Rev. 1-2009)
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