Form Wv/mft-504 - West Virginia Motor Fuel Supplier/permissive Supplier Report
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2STATE 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-504
WEST VIRGINIA MOTOR FUEL SUPPLIER/PERMISSIVE SUPPLIER REPORT
rtL159 v 4-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 and all required schedules must be completed and filed by the due date regardless of activity.
*COMPLETE BACK OF RETURN FIRST*
Period Ending:
Due Date:
FINAL
AMENDED
TOTAL TAX CALCULATION
1.
Grand Total Tax Due (Section 2 Line 1)
.
2.
Distributor Discount (Worksheet A - Total from Line 10)
.
Only if filed timely. Maximum of $5,000
3.
Administrative Discount (Line 1 multiplied by 0.001)
.
4.
Gross Amount Due (Line 1 minus Line 2 and Line 3)
.
Default Payment
Enter Distributor's Name:
5.
.
(Tax previously defaulted then paid)
(Use additional sheet if necessary)
Default Deduction (Amount not collected from Distributor/Importer)
6.
.
Must have submitted a Notice of Tax Payment Default Notice (WV/MFT-512)
7.
Total Amount Due (Line 4 plus Line 5 minus Line 6)
.
Period Ended:
(MM/YY)
8.
Previous Month Credit
.
Period Ended:
(MM/YY)
9.
Exporter Return Credit
.
10.
Total Credits (Line 8 plus Line 9)
.
11.
Net Amount Tax Due (Line 7 minus Line 10) If Line 10 is greater than Line 7, Enter 0
.
12.
NON-WAIVABLE INTEREST
.
13.
*ADDITIONS TO TAX (5% per month, not to exceed 25%; if no tax due $50 per month)
.
14.
TOTAL TAX AND LATE FILING CHARGES DUE (Add Lines 11 through 13)
.
15.
Overpayment Amount (Line 10 minus Line 7) If Line 7 is greater than Line 10, Enter 0
.
16.
CREDIT (To take credit on next monthly return, enter the total from Line 15)
.
17.
REFUND (To obtain a refund, enter the total from Line 15)
.
In addition to interest, a penalty of 5% per month (not to exceed 25%) is imposed if the return is late. Multiply Line 11 by 0.05 by the number of
*
months late. If no tax is due, a late filing penalty of $50 per month for each month or part of a month after the due date must be remitted.
MAIL TO: WEST VIRGINIA STATE TAX DEPARTMENT
Tax Account Administration Div
P.O. Box 2991, Charleston, WV 25330-2991
FOR ASSISTANCE CALL (304) 558-3333 TOLL FREE (800) 982-8297
For more information visit our web site at:
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File online at https://mytaxes.wvtax.gov
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