Form 720x - Amended Quarterly Federal Excise Tax Return Page 4

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Form 720X (Rev. 3-2013)
Page
(as shown above). You must include any information that is requested in the
Alternative fuel mixture credit. Claimant produced a mixture by mixing
Instructions for Form 720 (Rev. January 2011), for Form 720, lines 12, 13,
taxable fuel with alternative fuel. Claimant certifies that it (a) produced the
and 14. For example, the Certificate for Biodiesel and, if applicable,
alternative fuel, or (b) has in its possession the name, address, and EIN of
Statement of Biodiesel Reseller must be attached to Form 720X if it is the
the person(s) that sold the alternative fuel to the claimant; the date of
first claim filed that is supported by the certificate or statement. See the
purchase; and an invoice or other documentation identifying the amount of
Instructions for Form 720 (Rev. January 2011) for more information.
the alternative fuel. The claimant also certifies that it made no other claim for
the amount of the alternative fuel, or has repaid the amount to the
Certifications. On line 6 or a separate sheet of paper, you must include the
government. The alternative fuel mixture was sold by the claimant to any
applicable statement shown below.
person for use as a fuel or was used as a fuel by the claimant.
Alcohol fuel mixture credit (for mixtures produced, and sold, used, or
Signature
removed, on or before December 31, 2011). Claimant produced an alcohol
fuel mixture by mixing taxable fuel with alcohol. The alcohol fuel mixture was
Form 720X must be signed by a person authorized by the entity to sign this
sold by the claimant to any person for use as a fuel or was used as a fuel by
return. You must sign Form 720X even if it is filed with Form 720 to apply an
the claimant.
overpayment.
Biodiesel mixture credit. Claimant produced a mixture by mixing
Paid Preparer Use Only
biodiesel with diesel fuel. The biodiesel used to produce the mixture met
ASTM D6751 and met EPA’s registration requirements for fuels and fuel
A paid preparer must sign Form 720X and provide the information in the Paid
additives. The mixture was sold by the claimant to any person for use as a
Preparer Use Only section at the end of the form if the preparer was paid to
fuel or was used as a fuel by the claimant. Claimant has attached the
prepare the form and is not an employee of the filing entity. Paid preparers
Certificate for Biodiesel and, if applicable, the Statement of Biodiesel
must sign paper forms with a manual signature. The preparer must give you
Reseller.
a copy of the form in addition to the copy to be filed with the IRS.
Renewable diesel mixture credit. Claimant produced a mixture by mixing
If you are a paid preparer, enter your Preparer Tax Identification Number
renewable diesel with liquid fuel (other than renewable diesel). The
(PTIN) in the space provided. Include your complete address. If you work for
renewable diesel used to produce the renewable diesel mixture was derived
a firm, you also must enter the firm’s name and the EIN of the firm. However,
from biomass, met EPA’s registration requirements for fuels and fuel
you cannot use the PTIN of the tax preparation firm in place of your PTIN.
additives, and met ASTM D975, D396, or other equivalent standard
approved by the IRS. The mixture was sold by the claimant to any person for
You can apply for a PTIN online or by filing Form W-12, IRS Paid Preparer
use as a fuel or was used as a fuel by the claimant. Claimant has attached
Tax Identification Number (PTIN) Application and Renewal. For more
the Certificate for Biodiesel and, if applicable, Statement of Biodiesel
information about applying for a PTIN online, visit the IRS website at
Reseller, both of which have been edited as discussed in the Instructions for
Form 720 (Rev. January 2011).

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