Form Wv/ifta-13 - International Fuel Tax Agreement (Ifta) Quarterly Report Page 4

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WV/IFTA-13
rtL271V 7-Web
Account #:
INTERNATIONAL FUEL TAX AGREEMENT (IFTA) QUARTERLY REPORT
SECTION 2 - FUEL SUMMARY REPORT
1
2
3
4
(A) Jurisdiction *
(Check box for Surcharge)
(B) Fuel Type **
(C) Total Miles in
.
.
.
.
00
00
00
00
Jurisdiction
(D) Taxable Miles
.
.
.
.
00
00
00
00
in Jurisdiction
(E) Taxable Gallons
.
.
.
.
(D/MPG)
00
00
00
00
(F) Tax Paid Gallons
.
.
.
.
00
00
00
00
in Jurisdiction
(G) Net Taxable
.
.
.
.
00
00
00
00
Gallons (E-F)
(H) Tax Rate ***
0
.
0
.
0
.
0
.
(I) Tax / Credit Due
.
.
.
.
(G x H)
(J) Interest Due
.
.
.
.
(1% per month)
(K) Total Due
I + J
.
.
.
.
5
6
7
8
(A) Jurisdiction *
(Check box for Surcharge)
(B) Fuel Type **
(C) Total Miles in
.
.
.
.
00
00
00
00
Jurisdiction
(D) Taxable Miles
.
.
.
.
00
00
00
00
in Jurisdiction
(E) Taxable Gallons
.
.
.
.
(D/MPG)
00
00
00
00
(F) Tax Paid Gallons
.
.
.
.
00
00
00
00
in Jurisdiction
(G) Net Taxable
.
.
.
.
00
00
00
00
Gallons (E-F)
(H) Tax Rate ***
0
0
0
0
.
.
.
.
(I) Tax / Credit Due
.
.
.
.
(G x H)
(J) Interest Due
.
.
.
.
(1% per month)
(K) Total Due
.
.
.
.
I + J
.
Page Totals (I)
*
Enter two-character state code.
.
Page Totals (J)
Surcharge currently applicable to IN, KY, and VA only.
Enter two-character fuel code from Page 2.
**
Refer to for current tax rates.
***
O
6
0
0
9
0
9
0
3
A

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