Fillable Form Wv/mft-507 - West Virginia Motor Fuel Transporter Report printable pdf download

Form Wv/mft-507 - West Virginia Motor Fuel Transporter Report

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STATE OF WEST VIRGINIA

State Tax Department, Tax Account Administration Div

P.O. Box 2991

Charleston, WV 25330-2991

Name

Address

Account #:

City

State

Zip

WV/MFT-507

WEST VIRGINIA MOTOR FUEL TRANSPORTER REPORT

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Effective January 1, 2012, the motor fuel excise tax rate increased from 32.2 cents per gallon to 33.4 cents per gallon. Returns

and refund applications have been updated. Please use the correct rate for periods after January 1, 2012.

This report and all required schedules must be completed and filed by the due date regardless of activity.

Period Ending:

Due Date:

FINAL

AMENDED

PRODUCT LOAD INFORMATION

Report in whole gallons

GROSS GALLONS

NET GALLONS

Gallons loaded in West Virginia at a Terminal or Bulk Plant and delivered to

another state (Schedule 1).

Gallons loaded in another state at a Terminal or Bulk Plant and delivered into

West Virginia (Schedule 2).

Gallons loaded in West Virginia and delivered into West Virginia (Schedule 3).

Total Gallons of Motor Fuel Transported (Add Lines 1, 2, and 3)

Late File Penalty ($50 per month)

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)

MAIL TO: WEST VIRGINIA STATE TAX DEPARTMENT