Form Rmft-71 - Liquefied Petroleum Gas Tax Return

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Illinois Department of Revenue
  
RMFT-71 
Liquefied Petroleum Gas Tax Return 
Do not write above this line.
Part 1:  Identify yourself
Name __ ________________________________________________
________/________
Reporting period
Month
Year
-
Address __ ______________________________________________
LP
LP gas user's/seller's no. ________________________________
Number and street
_______________________________________________________
Telephone no. (_______)_________________________________
City
State
ZIP
Note:
You must account for motor fuel in gallons. If
Part 2:  Figure your tax
you made your purchases or sales in liters, multiply the
amount of liters by .2641721.
For official use
Do not write in
this column.
1
1
Write the number of gallons you used in motor vehicles on public highways.
___________________ ____________
2
2
Write the number of gallons you sold for motor fuel within Illinois from Part 3, Line j.
___________________ ____________
3
3
Add Lines 1 and 2. This is your total taxable gallonage.
___________________ ____________
4
4
Multiply Line 3 by 19 cents (.19).
___________________ ____________
5
Write the total credit you would like to apply. (Attach the original credit memorandum.)
Credit no.
__________
__________
__________
__________
__________
5
Credit amt. __________
__________
__________
__________
__________
___________________ ____________
6
6
Subtract Line 5 from Line 4. This is the total amount of tax you owe.
___________________ ____________
Make your check payable to "Illinois Department of Revenue, Motor Fuel Tax."
Part 3:  Complete your sales schedule
If you sold liquefied petroleum (LP) gas to be used as motor fuel on public highways, complete the following information.
Customer's name 
Customer's address 
Gallonage
a
a   
_______________________________________
______________________________________
_ _______________________
b
b
_______________________________________
______________________________________
________________________
c
c
_______________________________________
______________________________________
________________________
d
d 
_______________________________________
______________________________________
________________________
e
e
  ________________________
_______________________________________
______________________________________
f
f
_______________________________________
______________________________________
________________________
g
g 
_______________________________________
______________________________________
________________________
h
h 
_______________________________________
______________________________________
________________________
i
i
_______________________________________
______________________________________
________________________
j
j
  ________________________
Add Lines a through i. This is your total gallons sold. Write this amount on Part 2, Line 2.
Part 4:  Sign below
Under penalties of perjury, I state that I have examined this return and, to the best of my knowledge, it is true, correct and complete. The
information in this return is taken from the records of the business for which it is filed.
______________________________________________
____________________________________________
_____________________________
Taxpayer's signature
Title
Preparer's signature
Date
Company name
Mail your return to: MOTOR FUEL TAX
ILLINOIS DEPARTMENT OF REVENUE
Reset
Print
PO BOX 19019
SPRINGFIELD IL 62794-9019
RMFT-71 front (R-05/11)

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