Schedule 3 (Form 8849) - Certain Fuel Mixtures And The Alternative Fuel Credit
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1
2Certain Fuel Mixtures
Schedule 3
(Form 8849)
and the Alternative Fuel Credit
OMB No. 1545-1420
(Rev. January 2014)
Attach to Form 8849. Do not file with any other schedule.
▶
Department of the Treasury
Information about Schedule 3 (Form 8849) and its instructions is at
Internal Revenue Service
▶
Name as shown on Form 8849
EIN or SSN
Total refund (see instructions)
$
Caution. The alternative fuel credit must first be taken on Form 720 as a credit against your alternative fuel or compressed natural gas (CNG)
tax liability. If you have these tax liabilities and you did not make the claim on Schedule C (Form 720) as a credit against those liabilities, you
must first file Form 720X, Amended Quarterly Federal Excise Tax Return, before Form 8849, Schedule 3, can be used for the refund. You
cannot claim any amounts on Form 8849 that you claimed (or will claim) on Schedule C (Form 720), Form 720X, or Form 4136, Credit for
Federal Tax Paid on Fuels.
The alternative fuel mixture credit cannot be claimed on this form or on Form 4136. It must be taken as a credit against your taxable fuel
liability (gasoline, diesel fuel, and kerosene) reported on Form 720.
Claimant’s registration no.
▶
Enter your registration number, including the prefix. Line 3 claimants must enter their AL or AM registration number.
Period of claim: Enter month, day, and year in
MMDDYYYY format.
From
To
▶
▶
1
Reserved
Reserved
(c) Amount of claim
(a)
(b)
(d)
Rate
Gallons of alcohol
CRN
Multiply col. (a) by col. (b).
a
Reserved
b
Reserved
2
Reserved
Reserved
(b)
(a)
Gallons of
(c) Amount of claim
(d)
Rate
biodiesel or
Multiply col. (a) by col. (b)
CRN
renewable diesel
a
$
Reserved
b
Reserved
c
Reserved
3
Alternative Fuel Credit
(b)
(a)
(d)
(c) Amount of claim
Gallons or
Rate
CRN
Multiply col. (a) by col. (b)
gasoline gallon
equivalents (GGE)
a
$
Reserved
b
Reserved
c
Reserved
d
$
Liquefied hydrogen
429
.50
e
Reserved
f
Reserved
g
Reserved
h
Reserved
i
Reserved
Send this schedule with completed Form 8849 to: Internal Revenue Service, P.O. Box 312, Covington, KY 41012-0312; on the envelope write “Fuel Mixture Claim.”
For Privacy Act and Paperwork Reduction Act Notice, see Form 8849 instructions.
Cat. No. 27451F
Schedule 3 (Form 8849) (Rev. 1-2014)
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