Fillable Form Wv/mft-506 - West Virginia Motor Fuel Backup Tax Report printable pdf download

Form Wv/mft-506 - West Virginia Motor Fuel Backup Tax 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-506

WEST VIRGINIA MOTOR FUEL BACKUP TAX REPORT

rtL155 v 5-web

Effective January 1, 2013, the motor fuel excise tax rate increased from 33.4 cents per gallon to 34.7 cents per gallon. Returns

and refund applications have been updated. Please use the correct rate for periods after January 1, 2013.

This report is not required if no reportable activity. Reports with activity must be postmarked by the last

day of the month following report month.

Period Ending:

Due Date:

AMENDED

BACKUP TAX COMPUTATION

(Column 1)

(Column 2)

(Col 3)

(Column 4)

Total Gallons

Rate

Tax Due

(Column 2 X Column 3)

Motor Fuel exempt from the flat rate used on-highway

0.2050

Motor Fuel used on-highway after receiving a refund

0.2050

of tax for off highway use

Motor Fuel used on-highway previously un-taxed

0.3470

BALANCE OF TAX DUE (Add Column 4, Lines 1, 2, and 3)

NON-WAIVABLE INTEREST

ADDITIONS TO TAX (5% per month, not to exceed 25%; if no tax due $50 per month)

TOTAL TAX AND LATE FILING CHARGES DUE (Add Lines 4 through 6)

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)

MAIL TO: WEST VIRGINIA STATE TAX DEPARTMENT