Form Wv/mft-514 - West Virginia Motor Fuel Producer Report Page 2
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1
2WV/MFT-514
WEST VIRGINIA MOTOR FUEL PRODUCER REPORT
rtL156V 6-Web
Letter Id:
WORKSHEET A
(Report in Whole Gallons)
A
B
C
D
Total Gallons
Date
Total Produced Product
Total Undyed Fuel Added
Undyed Product
Product
Product
Gallons
Gallons
(MM/DD/YYYY)
Column B plus Column C
Code
Code
.
00
.
00
.
00
00
00
00
.
.
.
00
00
00
.
.
.
00
00
00
.
.
.
.
00
.
00
.
00
00
00
00
.
.
.
1.
Total Gallons (Add all Column D)
00
.
2.
Tax-Paid Gallons (Must Provide Invoices)
.
00
3.
Grand Total Taxable Gallons (Line 1 minus Line 2 - Enter here and on Line 1 on front of report)
00
.
WORKSHEET B
(Report in Whole Gallons)
A
B
C
D
Total Gallons
Date
Total Produced Product
Total Dyed Fuel Added
Dyed Product
Product
Product
Gallons
Gallons
Column B plus Column C
(MM/DD/YYYY)
Code
Code
00
00
00
.
.
.
.
00
.
00
.
00
00
00
00
.
.
.
00
00
00
.
.
.
00
00
00
.
.
.
.
00
.
00
.
00
1.
Total Gallons (Add all Column D)
.
00
2.
Tax-Paid Gallons (Must Provide Invoices)
.
00
3.
Grand Total Taxable Gallons (Line 1 minus Line 2 - Enter here and on Line 6 on front of report)
00
.
Sign Your Return
Under penalties of perjury, I declare that I have examined this return (including accompanying schedules and statements) and to the best of my knowledge
and belief it is true and complete.
(Signature of Taxpayer)
(Name of Taxpayer - Type or Print)
(Title)
(Date)
(Person to Contact Concerning this Return)
(Telephone Number)
(E-mail Address)
(Signature of preparer other than taxpayer)
(Address)
(Date)
Page 2 of 2
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