Form 3992 - Fuel Importer Return Page 2

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Form 3992, Page 2
See instructions for further schedule information.
Ethanol Blends
Undyed Petroleum
Undyed Biodiesel
Dyed Diesel
PART 2: REPORTABLE INFORMATION
Schedule
Gasoline
Aviation
(E70 - E99)
Diesel
(B05 or higher)
(petroleum/biodiesel)
2C
21. Imports from outside the United States.
3B
22. Imports from bulk storage outside Michigan.
11A
23. Dyed diesel diverted TO Michigan.
PART 3: TAXABLE DISBURSEMENTS
5/5Z
24. Michigan taxable gallons.
5C
25. Aviation fuel sold to authorized resellers.
5F
26. Dyed diesel fuel disbursed for taxable use.
27. Taxable gallons. Add lines 24-26.
PART 4: DIRECT DELIVERIES OF IMPORTS
6F
28. Dyed diesel disbursements.
8
29. Deliveries to U.S. Government.
9
30. Deliveries to state and local governments.
6Z
31. Leaded Racing Fuel disbursements.
10G
32. Deliveries to exempt institutions.
10M
33. Deliveries to fuel feedstock users.
34. Non-taxable use.
11B
35. Diversions FROM Michigan.
Preparer's Signature
Printed Name
Preparer's Address
Telephone Number
Preparer FEIN
Mail refund requests or zero return to:
Mail Remittance to:
Michigan Department of Treasury
Michigan Department of Treasury
Motor Fuel Unit
P.O. Box 77401
P.O. Box 30474
Detroit, MI 48278
Lansing, MI 48909-7974
Send your payment with a Motor Fuel Tax Payment/Proposed Adjustments Coupon, form number 4020. Make check payable to "State of Michigan-Motor Fuel." Print your account
number on your check. Questions? Call (517) 636-4600.

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