Form Rpd-41306 - Combined Fuel Tax Report For Distributors, Suppliers And Wholesalers

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RPD-41306
*96540200*
Rev. 05/03/2013
State of New Mexico - Taxation and Revenue Department
COMBINED FUEL TAX REPORT
FOR DISTRIBUTORS, SUPPLIERS AND WHOLESALERS
__________________
Report for month of
mm/dd/ccyy
Due by the 25th of the month following the close of the report month.
Check one:
Original
Amended
Mail to: New Mexico Taxation & Revenue
Type of business:
Department
Distributor
Special Tax Programs and Services
FEIN or CRS ID
P.O. Box 25123
Supplier
Name
Santa Fe, NM 87504-5123
Wholesaler
Indian Distributor
For assistance call (505) 827-0765
Mailing
Address
Reporting Method:
Gross gallons
Net gallons
GASOLINE
ETHANOL
SPECIAL FUEL
Do not include dyed diesel in Inventory Reconciliation, Lines 1 through 6 below.
Column 1
Column 2
Column 3
1.
Beginning physical inventory: (Must agree with prior month’s ending inventory.) 1
2.
Receipts: (From line 9 on page 2.) ........................................................................... 2
(
) (
) (
)
3.
LESS: Disbursements: (From line 25 on page 2.) .................................................. 3
4.
Transfers and prior-period adjustments: ............................................................. 4
5.
Gain or (loss): (Retain explanation in your records.) ............................................... 5
6.
Ending physical inventory: (Must agree with actual ending inventory.) ................. 6
7.
Total taxable gallons received: (From line 5 on page 2.) ....................................... 7
8.
LESS: Sales of non-taxable gallons: (From line 23 on page 2.) ............................ 8
9.
Taxable gallons: (Line 7 minus line 8.) .................................................................... 9
0.17
0.17
0.21
10. Fuel tax rate: ......................................................................................................... 10
0.01875
0.01875
0.01875
11. Petroleum products loading fee: (PPLF) Subject to change each October 1. .....11
12. Fuel tax due: (Multiply line 9 X line 10.) DO NOT ENTER on this line if negative,
instead report negative amount on line 19b.. .......................................................... 12
13. PPLF due: (Multiply line 9 X line 11.) DO NOT ENTER on this line if negative,
instead report negative amount on line 15a. .......................................................... 13
14. Deductable gallons subject to PPLF: Gallons sold or deducted on Form RPD-
41306, page 2, lines 10, 16, 18, 20 and 22. These gallons are subject to PPLF
and deducted from gasoline or special fuel excise tax. ........................................... 14
15. Additional PPLF due from line 14: (Multiply line 11 X line 14.) ............................ 15
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) (
) (
)
15a. PPLF Negative amount: .................................................................................... 15a
15b. Total PPLF due: (Enter sum of lines 15 and 15a.) DO NOT ENTER on this line
if negative, instead report negative amount on line 19b. ....................................... 15b
16. Total tax due: (Enter sum of lines 12, 13 and 15b.) ............................................... 16
17. Late payment penalty due: (Multiply line 16 X .02 per month or partial month -
20% maximum or a minimum of $5. Enter $5 minimum in Column 1 only.) ............ 17
18. Interest due: (Multiply line 16 X daily interest rate X number of days late). ........... 18
19a. Tax, penalty and interest due for each column: (Enter the sum of lines 16,
17 and 18.) ............................................................................................................ 19a
19b. Overpayment: (Do not net overpayment against tax, penalty and interest due
reported on line 19a, columns 1, 2 or 3. Attach Form RPD-41071 to obtain a
(
) (
) (
)
refund.) .................................................................................................................. 19b
20. Wholesalers late filing penalty: (See instructions.) ............................................. 20
21. Total due - payment amount: (Sum line 19a of columns 1, 2 and 3.
Wholesalers see instructions) ................................................................................. 21
22. Total paid with this report: (If ACH payment is made, enter zero (0).) ................. 22
I declare that I have examined this return, including any accompanying schedules and statements, and to the best of my knowledge and belief it is true, correct and complete.
Date
Telephone number
Signature of authorized agent
Title
E-mail address
FAX number
Printed name of authorized agent

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