FORM M-20A (REV. 2015)
PAGE 2
Name
Permit Number
Month Ending
__ __ / __ __
(MM/YY)
PART I — COMPUTATION OF FUEL TAX AND ENVIRONMENTAL RESPONSE,
ENERGY, AND FOOD SECURITY TAX
FBF152
(a)
(b)
(c)
(d)
(e) Add cols. a to d
LIQUID FUEL CLASSIFICATION
CITY & COUNTY
COUNTY OF MAUI
COUNTY OF
COUNTY OF
TOTAL OF ALL
(Use Part II Summary)
OF HONOLULU
HAWAII
KAUAI
COUNTIES
Off Highway Liquid Fuel
27. Aviation
Gals.
27
28. Diesel - Off Hwy.
Gals.
28
29. Total (Add lines 27 and 28)
Gals.
29
2¢
2¢
2¢
2¢
30.
Tax Rate
31. Total Tax for Off Highway Aviation and Diesel Oil
31
32. Naphtha - Power-Generating Facility Gals.
32
b
2¢
2¢
2¢
2¢
33.
Tax Rate
34. Total Tax for Off Highway Naphtha
34
Liquid Fuel for Small Boats (See Instructions.)
35. Diesel
Gals.
35
2¢
2¢
2¢
2¢
36.
Tax Rate
37. Total Tax for Diesel Oil
37
38. Gasoline
Gals.
38
33.5¢
35¢
25.8¢
34¢
b
39.
Tax Rate
40. Total Tax for Gasoline
40
41. Grand Total Gallons - Add lines 3, 6, 9,
41
12, 15, 18, 21, 24, 29, 32, 35, and 38
42. Total Fuel Tax - Add lines 5, 8, 11, 14,
42
17, 20, 23, 26, 31, 34, 37, and 40
ENVIRONMENTAL RESPONSE, ENERGY, AND FOOD SECURITY TAX
a
43a. Petroleum Products
43a
$1.05
43b.
Tax Rate
43b
43
43. Total Environmental Response, Energy, and Food Security Tax on Petroleum Products
Multiply line 43a by 43b .................
c
44a. Fossil Fuel Products
44a
c
$0.19
44b
Tax Rate
44b
44
44c. Total Environmental Response, Energy, and Food Security Tax on Fossil Fuel Products
Multiply line 44a by 44b ..............
45. Total Environmental Response, Energy, and Food Security Tax — Add lines 43 and 44 ...........................................................
45
46. TOTAL TAXES DUE — Add line 42, column (e) and line 45 .....................................................................................................
46
47. AMENDED RETURN ONLY – Amount paid on original return. (See Instructions) ....................................................................
47
48. AMENDED RETURN ONLY – Balance due (refund) with amended return. (See Instructions) .................................................
48
Complete Parts II, III, and IV on pages 3 and 4
a Does not include aviation fuel.
b Effective July 1, 2015, pursuant to Maui County Resolution No. 15-54.
c Effective July 1, 2015, pursuant to Act 185, SLH 2015.
d Effective July 1, 2015, LNG calculation is based on the energy content of 128,714 BTU.
e Effective July 1, 2015, CNG calculation is based on the energy content of 128,621 BTU.
FORM M-20A