E-581
Interstate Carrier Claim for Refund
State and County Sales and Use Taxes
Web-Fill
7-11
North Carolina Department of Revenue
Legal Name (First 32 Characters)
(USE CAPITAL LETTERS FOR YOUR NAME AND ADDRESS)
Account ID
Mailing Address
FEIN or SSN
City
State
Zip Code
County
Period Beginning (MM-DD-YY)
Name of Person We Should Contact if We Have Questions About This Claim
Contact Telephone
Period Ending (MM-DD-YY)
Name of Taxing County
(If more than one county, complete reverse)
1.
Total Miles of Operation
2.
Miles Operated in North Carolina
3.
Ratio of Miles Operated in North Carolina
(Line 2 divided by Line 1; carry decimal amount to four places (Ex: .7546))
4.
Total Purchases of Railway Cars, Locomotives, Fuel, Lubricants, Repair Parts, and
Accessories Inside and Outside N.C. (Do not include any sales or use tax paid)
5.
Purchases Per Mileage Ratio (Multiply Line 4 by Line 3)
6.
N.C. State Sales and Use Tax Paid on Purchases of Railway Cars, Locomotives, Fuel,
Lubricants, Repair Parts, and Accessories (Enter only the amount of tax paid at the 4.75%
State rate)
7.
State Tax on Purchases Per Mileage Ratio (Multiply Line 5 by 4.75% State rate)
8.
Amount of State Sales and Use Tax Refund (Line 6 minus Line 7)
9.
Ratio of County Sales and Use Tax Refund
(Line 8 divided by Line 6; carry decimal amount to four places (Ex: .7546))
10.
County Sales and Use Tax Paid on Purchases of Railway Cars, Locomotives, Fuel, Lubricants,
Repair Parts, and Accessories
County 2.0% Tax
County 2.25% Tax
Mecklenburg Transit 0.5% Tax
11.
Amount of County Tax Refund (Multiply the amounts of tax for each county rate on Line 10 above by Line 9. If you
are claiming a refund of more than one county’s tax, complete the reverse)
County 2.0% Tax
County 2.25% Tax
Mecklenburg Transit 0.5% Tax
$
12.
Total Refund Requested (Add State tax on Line 8 and county tax at all rates on Line 11)
Signature:
Date:
I certify that, to the best of my knowledge, this claim is accurate and complete.
Title:
Telephone:
MAIL TO: NC Department of Revenue, P.O. Box 25000, Raleigh, NC 27640-0001
For Departmental Use Only
Refund Approved:
State Tax
County Tax
Total Tax
,
,
.
,
,
.
,
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As Filed
As Corrected
By:
Date: