Form 4136 - Credit For Federal Tax Paid On Fuels - 2015 Page 2
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Form 4136 (2015)
Page
5
Kerosene Used in Aviation (see Caution above line 1)
(a) Type of use
(b) Rate
(c) Gallons
(d) Amount of credit
(e) CRN
a
Kerosene used in commercial aviation (other than foreign
trade) taxed at $.244
$
$ .200
417
b
Kerosene used in commercial aviation (other than foreign
trade) taxed at $.219
.175
355
c
Nontaxable use (other than use by state or local
government) taxed at $.244
.243
346
d
Nontaxable use (other than use by state or local
government) taxed at $.219
.218
369
e
LUST tax on aviation fuels used in foreign trade
.001
433
6
Sales by Registered Ultimate Vendors of Undyed Diesel Fuel
Registration No.
▶
Claimant certifies that it sold the diesel fuel at a tax-excluded price, repaid the amount of tax to the buyer, or has obtained the written consent
of the buyer to make the claim. Claimant certifies that the diesel fuel did not contain visible evidence of dye.
Exception. If any of the diesel fuel included in this claim did contain visible evidence of dye, attach an explanation and check here
▶
(b) Rate
(c) Gallons
(e) CRN
(d) Amount of credit
a
Use by a state or local government
$
$ .243
360
b
Use in certain intercity and local buses
.17
350
Sales by Registered Ultimate Vendors of Undyed Kerosene (Other
7
Than Kerosene For Use in Aviation)
Registration No.
▶
Claimant certifies that it sold the kerosene at a tax-excluded price, repaid the amount of tax to the buyer, or has obtained the written consent
of the buyer to make the claim. Claimant certifies that the kerosene did not contain visible evidence of dye.
Exception. If any of the kerosene included in this claim did contain visible evidence of dye, attach an explanation and check here
▶
(b) Rate
(c) Gallons
(d) Amount of credit
(e) CRN
}
a
Use by a state or local government
$ .243
b
Sales from a blocked pump
$
.243
346
c
Use in certain intercity and local buses
.17
347
8
Registration No.
Sales by Registered Ultimate Vendors of Kerosene For Use in Aviation
▶
Claimant sold the kerosene for use in aviation at a tax-excluded price and has not collected the amount of tax from the buyer, repaid the
amount of tax to the buyer, or has obtained the written consent of the buyer to make the claim. See the instructions for additional information
to be submitted.
(a) Type of use
(b) Rate
(c) Gallons
(e) CRN
(d) Amount of credit
a
Use in commercial aviation (other than foreign trade) taxed
at $.219
$
$ .175
355
b
Use in commercial aviation (other than foreign trade) taxed
at $.244
.200
417
c
Nonexempt use in noncommercial aviation
.025
418
d
Other nontaxable uses taxed at $.244
.243
346
e
Other nontaxable uses taxed at $.219
.218
369
f
LUST tax on aviation fuels used in foreign trade
.001
433
4136
Form
(2015)
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