MF 2
Rev. 8/13
P.O. Box 530
Columbus, OH 43216-0530
Licensed Dealer’s Monthly Ohio Motor Fuel Tax Report
Dealer name
FEIN
Month/Year
Street
City
State
ZIP
Check here to cancel account
Effective date
Check here if address is new
(Use whole gallons only)
Transfer Totals From Fuel Schedule Recaps
1. Gasoline (Schedule Recap MF 2A line 9) ......................................................................... 1.
2. Dyed low sulfur diesel (Schedule Recap MF 2B line 13) .................................................. 2.
3. Kerosene (Schedule Recap MF 2C line 16) ..................................................................... 3.
4. Clear diesel (Schedule Recap MF 2D line 15) .................................................................. 4.
5. This line intentionally left blank ......................................................................................... 5.
6. Miscellaneous fuels (Schedule Recap MF 2F line 8) ........................................................ 6.
7. Gross taxable gallons (add lines 1 through 6) .................................................................. 7.
8. Shrinkage allowance/discount (multiply line 7 by appropriate percentage – see line
instructions for new rates effective July 1, 2011) .............................................................. 8.
9. Retail shrinkage (multiply gallons sold to retailers by retailer percentage – see line
instructions for new rates effective July 1, 2011) .............................................................. 9.
10. Net taxable gallons (line 7 plus line 9 minus line 8) ........................................................ 10.
$
11. Gross tax (multiply line 10 by applicable tax rate – see instructions) ..............................11.
12. This line intentionally left blank ....................................................................................... 12.
13. This line intentionally left blank ....................................................................................... 13.
$
14. Tax due (line 11) .............................................................................................................. 14.
$
15. Late fi ling charge (see instructions) ................................................................................ 15.
$
16. Interest (see instructions) ................................................................................................ 16.
$
17. Total amount due (add lines 14, 15 and 16) .................................................................... 17.
I declare under penalties of perjury that this report (including any accompanying schedules and statements) has been
examined by me and to the best of my knowledge and belief is a true, correct and complete report.
Authorized signature
Telephone
E-mail address
Date
This report must be fi led with the Ohio Department of Taxation, Motor Fuel Division, P.O. Box 530, Columbus, Ohio
43216-0530 and received by the last day of each month following the report period. Telephone inquiries: (855) 466-3921;
Fax: (614) 644-2816.