Form Ifta-100-Mn - Ifta Quarterly Fuel Use Tax Return
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1
2IFTA-100-MN
Reset Form
Use this form to report operations for the
.
quarter ending
Month
Day
Year
This return must be filed by the
last day of the month following
the end of the quarter.
Licensee IFTA identification number
MI
Name
Address change
Street address
No operation in
City
State
Zip Code
any jurisdiction
Cancel license
Amended return
IFTA Quarterly Fuel Use Tax Return
File this return even if there is no tax due.
Use this form for filing your Quarterly Fuel Use Tax Return as required under the International Fuel Tax Agreement (IFTA).
Read the instructions on the back carefully. Make a copy of this return for your records.
Attach check or money order payable to:
Enter the amount of
STATE OF MICHIGAN - IFTA.
your payment here
See Mailing Instructions on the back of this form.
$
Enter the Total from column Q of Form IFTA-101-MN, IFTA Quarterly Fuel Use Tax Schedule, for fuel types listed in lines 1
thru 4. For all other fuel types enter the Total Amount from column S of the worksheet on back of Form IFTA-101-I-MN.
Enter any credit amounts in brackets. Attach a Form IFTA-101-MN for each fuel type reported below.
1
1 Diesel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Motor fuel gasoline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
3 Ethanol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
4 Propane (LPG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
5 All other fuel types not listed in lines 1 thru 4 (from worksheet on back of IFTA-101-I-MN)
5
6 Subtotal of amount due or (credit)
. . . . . . . . . . . . . . . . . . . . . . . . .
6
(add lines 1 through 5)
7 Penalty (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
8 Total balance due or (credit)
8
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(add lines 6 and 7)
9 Credits to be applied . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
10
10 Balance due/(credit)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(subtract line 9 from line 8)
11
11 Refund amount requested
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
I certify that this business is duly licensed and that this return, including any schedules,
For Office Use Only
is to the best of my knowledge and belief true, correct and complete.
Sig
Corr
Authorized signature
Date
Taxpayer's phone number
(
)
Name/ID/Address
Official title
Paid preparer's EIN
Paid preparer's name or firm (if other than taxpayer)
Paid preparer's phone number
(
)
Paid preparer's address
MI
Paid preparer's signature
Date
Date Received
Please make a copy of this return for your records.
See Mailing Instructions on back.
IFTA-100-MN (4/06)
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