Schedule Db (Form Rmft-7-Df) - Motor Fuel Tax

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Illinois Department of Revenue
Page_____ of _____
Schedule DB
Motor Fuel Tax
Dyed Diesel Fuel sold for Nonhighway Use to the Federal Government, Authorized
Foreign Diplomats, Municipal Corporations Owning and Operating Local Transportation
Systems, and to Certain Privately Owned Public Utilities
Attach to Form RMFT-5
Step 1: Complete the following information
_______________________________________
Company name
_______________________________________
Your license number
Reporting period ___ ___/____ ____ ____ ____
Month
Year
Step 2: Report your nontaxable sales to the federal government, authorized foreign diplomats, etc.
1
2
3
4
5
6
7
8
Invoice date
Invoice or
Name of
Bill of lading
Origin
Destination
Invoiced
(month, day, year)
serial number
carrier
or manifest number
Name of purchaser
(Illinois cities only)
(Illinois cities only)
gallons
1 _ _/_ _/_ _ _ _ __________________________________________________________________________________________________________________
2 _ _/_ _/_ _ _ _ __________________________________________________________________________________________________________________
3 _ _/_ _/_ _ _ _ __________________________________________________________________________________________________________________
4 _ _/_ _/_ _ _ _ __________________________________________________________________________________________________________________
5 _ _/_ _/_ _ _ _ __________________________________________________________________________________________________________________
6 _ _/_ _/_ _ _ _ __________________________________________________________________________________________________________________
7 _ _/_ _/_ _ _ _ __________________________________________________________________________________________________________________
8 _ _/_ _/_ _ _ _ __________________________________________________________________________________________________________________
9 _ _/_ _/_ _ _ _ __________________________________________________________________________________________________________________
10 _ _/_ _/_ _ _ _ __________________________________________________________________________________________________________________
11 Add the invoiced gallons in Column 8, Lines 1 through 10. Write the total amount here.
11 ________________
12 If you are fi ling only one Schedule DB, write the amount from Line 11 here and on Form RMFT-5, Line 6, Column 3.
12 ________________
If you are fi ling more than one Schedule DB, add Line 11 from each schedule, and write the total on Line 12 of the last page.
Also write this amount on Form RMFT-5, Line 6, Column 3.
This form is authorized as outlined by the Motor Fuel Tax Law. Disclosure of this information is REQUIRED. Failure to provide
Information could result in a penalty. This form has been approved by the Forms Management Center.
IL-492-3981
RMFT-7-DF front (R-3/09)

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