Form 3891 - Refund Request For Prepaid Sales Tax On Fuel
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1Michigan Department of Treasury
3891 (Rev. 08-13)
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Refund Request for Prepaid Sales Tax on Fuel
This form is issued under the authority of the Sales Tax Act, P.A. 167 of 1933. Filing is voluntary.
Account Number
Registered Business Name
Address
City
State
ZIP Code
OVERPAYMENT DETAIL
Tax Reporting Period
Amount Overpaid
TOTAL OVERPAYMENT
CERTIFICATION
I certify under penalty of perjury that I have examined this request and to the best of my knowledge and belief, it is true and correct.
Authorized Signature
Telephone Number
Name and Title Printed
Date
Mail this form to:
Michigan Department of Treasury,
P.O. Box 30427,
Lansing, Michigan 48909.
For questions, call (517) 636-6925.
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Parent category: Financial