Form Wv/mfr-14-Worksheet - Schedule C - Retailers Of Clear Kerosene

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WEST VIRGINIA STATE TAX DEPARTMENT
Tax Account Administration Division, Excise Unit
PO BOX 2991
CHARLESTON, WV 25330-2991
Schedule C
RETAILERS OF CLEAR KEROSENE
Sold for Heating of Public/Private Dwellings
(Provide with the filing of the Motor Fuel Refund Application WV/MFR-14)
637UP-Registration Number (issued by IRS): ________________________________
FEIN or 8 Digit Acct No: _____________________________
Name: ____________________________________________
Address: __________________________________________
__________________________________________
Please select the quarter for which you are applying:
Sales Dated
Due Date
March 31
January 1 – March 31
April 30
June 30
April 1 – June 30
July 31
September 30
July 1 – September 30
October 31
December 31
October 1 – December 31
January 31
To qualify for a motor fuel excise tax refund, the retailer must meet the following
requirements:
1) Have a 637-UP registration as an ultimate vendor from a blocked pump, issued by the Internal
Revenue Service.
2) Must ensure that the undyed kerosene is for home heating use only.
3) Must ensure that the undyed kerosene is sold from a “blocked pump” at a fixed location.
4) The blocked pump is identified with a legible and conspicuous notice stating “UNDYED -
UNTAXED KEROSENE, NON -TAXABLE USE ONLY.
5) The undyed kerosene cannot reasonably be used to dispense fuel into the fuel supply tank of a
diesel-powered highway vehicle or train.
A “blocked pump” under federal regulations is a fuel dispenser that due to the physical limitations-
such as a short hose or a cement barrier-cannot be used to fuel a vehicle. As an alternative, a
blocked pump may be locked by a vendor after each sale and unlocked by the vendor in
response to a request by a customer for undyed kerosene for use other than as a fuel in a diesel-
powered highway vehicle or train. To make a claim with regard to undyed kerosene sold from this
latter type of blocked pump, the vendor must obtain the name and address of anyone who buys
more than five gallons of kerosene in a single sale, record the date and amount of sale to each
customer and retain these records for a minimum of three years.
WV/MFR-14-Worksheet
Rev 01/11

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