Fillable Form Wv/mft-511 - West Virginia Motor Fuel Exporter Report (Page 2 of 2) in pdf

Form Wv/mft-511 - West Virginia Motor Fuel Exporter Report Page 2

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WV/MFT-511

WEST VIRGINIA MOTOR FUEL EXPORTER REPORT

SECTION 3 - TAX DUE CALCULATION

Report in whole gallons

Gasoline

Gasohol

Undyed Diesel

Clear Kerosene / Other

Gallons Diverted into

West Virginia (Sch 11)

Combined Rate

0.3470

Tax Due - Combined Rate

(Line 1 times Line 2)

Report in whole gallons

Dyed Diesel and Kerosene

Propane

Aviation Gasoline

Aviation Jet Fuel

Gallons Diverted into WV

At Variable Rate (Sch 11)

Variable Rate

0.1420

Tax Due - Variable Rate

(Line 4 times Line 5)

7. Total Tax Due (Add all columns in Section 3 Line 3 and Line 6)

Check if applicable:

Schedule 7A / 7B Attached

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)

(Email Address)

(Signature of preparer other than taxpayer)

(Address)

(Date)

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