Form L-2195 - Motor Fuel Manufacturers Monthly Return
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6STATE OF SOUTH CAROLINA
1350
DEPARTMENT OF REVENUE
L-2195
MOTOR FUEL MANUFACTURERS MONTHLY RETURN
(Rev. 3/13/12)
Mail To:
South Carolina Department of Revenue,
4351
Motor Fuel, Columbia, SC 29214-0133.
License Number
MANUFACTURER
NAME AND ADDRESS
FEIN
Period Covered
USER FEE AND OTHER APPLICABLE FEE CALCULATIONS
1.
Total Gallons of Biodiesel (B100) Manufactured (Line 12 of calculation page)
2.
Total Gallons of Substitute Fuels Manufactured (Line 12 of calculation page)
3.
Total Gallons Manufactured (Line 1 + Line 2)
4.
Net Special Fuel User Fee Due (Line 3 x $.16)
5.
Penalty
6.
Interest
7.
Total Special Fuel User Fee Due (Line 4 + Line 5 + Line 6)
34-2105
8.
Inspection Fees Due (Line 13 of calculation page x $.0025)
9.
Penalty
10.
Interest
11.
Total Inspection Fees Due (Line 8 + Line 9 + Line 10)
34-2314
12.
Environmental Impact Fees Due (Line13 of calculation page x $.0050)
13.
Penalty
14.
Interest
15.
Total Environmental Impact Fees Due (Line 12 + Line 13 + Line 14)
34-2312
16.
Total Fees Due, Plus Penalty and Interest (Line 7 + Line 11 + Line 15)
43511021
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