Form Mvf 31 - Motor Fuel Refund Permit Application

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MVF 31
Rev. 12/08
Permit number assigned
P.O. Box 530
Columbus, OH 43216-0530
Motor Fuel Refund Permit Application
Pursuant to Ohio Revised Code Section 5735.16, I/we hereby apply for a motor fuel refund permit. The applicant understands
that this permit may be revoked by the tax commissioner if it is found that the permit holder has made a false or fraudulent
application for refund of tax or when the permit holder fails to furnish information required by law.
Under penalties of prosecution, no person shall make a false
or fraudulent statement on this application.
1. Name of applicant
(If you are a corporation, DO NOT use your name, use the corporation name.)
Ohio charter number
2. Trade name if other than above
3. Check whether applicant operates as:
Sole owner
Other (list)
4. If a corporation, date of qualifi cation
List name, address and SSN of all corporate offi cers and directors (attach separate sheet, if necessary)
5. If partnership, list name, address and SSN of all partners. If LLC or LLP, list name, address and SSN of all members
(attach separate sheet, if necessary).
6. Business address (P.O. boxes not acceptable)
7. County in which business is located
8. Mailing address (if other than that shown on line 6)
9. Explain how this fuel is being used in a refundable manner. Be specifi c.
10. Please provide a detailed list of the type of equipment that is using fuel in a refundable manner. Also provide us with
the quantity of each type of equipment operated. (Attach a separate sheet if necessary.)


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