Form Fe - Ferry Embarkation Fee
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1Rev. 11/12
Massachusetts
Form FE
Department of
Ferry Embarkation Fee
Revenue
This return is due on or before the 20th day of the month following the close of each calendar quarter.
Name
For the quarter ending
Address
Federal Identification number
3
City/Town
State
Zip
Ferry Embarkation Fee Calculation.
Complete the following for municipalities accepting the embarkation fee.
1 Total passenger trips (from Schedule A, line 7, col. a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1
2 Exempt trips for commuter excursion fares (from Schedule A, line 7, col. b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2
3 Exempt trips for school-related fares (from Schedule A, line 7, col. c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3
4 Trips subject to fee (from Schedule A, line 7, col. e) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4
$
.50
5 Fee rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 5
6 Fee amount due. Multiply line 4 by line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 6
7 Penalties. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
8 Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
9 Total amount due. Add lines 6 through 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 9
Schedule A. Trips Subject to Ferry Embarkation Fee
d.
e.
a.
b.
c.
Total exempt trips
Trips subject to fee
Add col’s. b and c
Subtract col. d from col. a
Total passenger trips
Exempt commuter trips
Exempt school trips
1. Barnstable
2. Falmouth
3. Nantucket
4. Oak Bluffs
5. Provincetown
6. Tisbury
7. Total. Add lines 1 through 6
Declaration
The undersigned certifies under the penalties of perjury that all items and statements herein contained are true and accurate in every particular.
Signature of authorized officer
Date
Phone number
Preparer’s signature and SSN or PTIN
Date
Check if self-employed
Employer Identification number
Firm name (or yours, if self-employed) and address
City/town
State
Zip
File this return and payment in full with: Massachusetts Department of Revenue, PO Box 7012, Boston, MA 02204.
Make check or money order payable to: Commonwealth of Massachusetts.
Privacy Act Notice
Under the authority of 42 U.S.C. sec. 405(c)(2)(C)(i), and M.G.L. c. 62C, sec. 5, the Department of Revenue has the right to require an individual to furnish his
or her Social Security number on a state tax return. This information is mandatory. The Department of Revenue uses Social Security numbers for taxpayer
identification to assist in processing and keeping track of returns and in determining and collecting the proper amount of tax due. Under M.G.L. c. 62C, sec.
40, the taxpayer’s identifying number is required to process a refund of overpaid taxes. Although tax return information is generally confidential pursuant to
M.G.L. c. 62C, sec. 21, the Department of Revenue may disclose return information to other taxing authorities and those entities specified in M.G.L. c. 62C,
secs. 21, 22 or 23, and as otherwise authorized by law.
printed on recycled paper
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