Fillable Form 4757 - Distributor'S Monthly Tax Report (Page 3 of 4) in pdf

INSTRUCTIONS FOR DISTRIBUTOR’S MONTHLY TAX REPORT

This report and its supporting schedules must be fully completed

14. Gallons of fuel exported fees paid (From worksheet, Line 14).

and mailed to the Missouri Department of Revenue along with any

15. Gallons subject to inspection fee (Line 13 minus (–) Line 14).

tax and/or fees due on the last day of each month for the purchases

16. Inspection fee due (Line 15 times (X) .0005).

made in the preceding calendar month unless such day falls on a

17. If you have an inspection fee credit from a previous report, you

week end or state holiday in which case the report, tax, and fees

will receive a letter. Enter the amount of your inspection fee

would be due the next succeeding business day. A report is due

credit and attach a copy of the authorization.

whether or not there were any activity during the month. You may

18. Total inspection fee due (Line 16 minus Line 17).

access the due date schedule at

Original reports and schedules must contain all the required

Transport Load Fee (Round to whole dollars)

information. Computer generated reports and schedules, approved

19. Total gallons of fuel subject to transport load fee (Line 15 above).

by the Department, must contain all the information required on the

original reports and schedules.

20. Motor fuel gallons sold to railroad corporations, airline com panies

or used as bunker fuel in vessels are not subject to the transport

Correcting Reports

load fee (Total from attached Schedule 10K, 10R, or 10Y).

Additional Report - adds or takes away any additional gallons from

21. Total gallons subject to transport load fee (Line 19 minus (–)

the original report. When filing an additional report, please report

Line 20).

only those gallons in which you are changing.

22. Transport load fee (Line 21 times (X) 0.0025).

Amended Report - filed when all or the majority of the information

23. If you have a transport load fee credit from a previous report,

originally reported is incorrect. This type of report will replace all

you will receive a letter. Enter the amount of your transport load

information that was first reported.

fee credit and attach a copy of the authorization.

24. Total transport load fee due (Line 22 minus Line 23).

YOU MUST ROUND TO WHOLE GALLONS AND DOLLARS

(Example: Round down if less than .50 and round up if .50 to .99)

Taxes and Fees Due (Round to whole dollars)

Taxable Gallons (Round to whole gallons)

25. Total motor fuel tax due (total from Line 12 Columns A, B, C, E,

and F).

1. Gallons of blend stock received tax and/or fees unpaid (From

26. Total aviation gasoline tax due (Total from Line 12 Column D).

worksheet, Line 6).

27. Total inspection fee due (Total from Line 18).

2. Gallons of fuel received in Missouri tax and/or fees unpaid.

Attach an explanation with Schedule 2A (From worksheet, Line

28. Total transport load fee due (Total from Line 24).

5). Tank wagon operators report fuel imported into Missouri on

29. Total taxes and fees due (Lines 25, 26, 27, and 28).

this line.

3. Gallons of tax exempt product blended (For taxable use) (From

Penalty (Round to whole dollars)

work sheet, Line 17).

30. If your report is not filed on a timely basis or taxes are not paid

4. Gallons of dyed fuel sold for taxable purposes (From worksheet,

timely (filed and received by the United States Post Office

Line 11).

cancellation stamped upon the envelope), you are subject to a

5. Gallons subject to tax and/or fees (Total of Lines 1, 2, 3, and 4).

penalty of five percent per month up to 25 percent of the total

6. Gallons of fuel exported (Missouri tax and/or fees paid) (From

amount of tax (Line 29 times (X) penalty amount, 5 percent up

worksheet, Line 14).

to 25 percent).

7. Calculate allowance. Line 6 times (X) the appropriate

Interest (Round to whole dollars)

per cent age. (Applies only when supplier passed allowance to

purchaser of Missouri tax paid fuel.)

31. Interest is due on any late payment (Line 29 times

(X) the annual interest rate, multiplied by (X) the

8. Net gallons exported of Missouri tax paid fuel. (Line 6 minus (–)

number of days late divided by 365 (366 for leap years)).

Line 7).

The annual interest rate is subject to change each year. You

9. Net gallons subject to tax and/or fees (Line 5 minus (–) Line 8).

may access the annual interest rate on the Department’s web

site at:

Tax Calculation (Round to whole dollars)

32. Total taxes, fees, penalty, and interest due (Lines 29, 30, and 31).

Tax rate for gasoline, alcohol blended with gasoline, gasohol and

other products blended with gasoline, clear diesel, clear ker o sene

Pool Bond Payment (Participants Only)

and other products blended with clear diesel or clear kerosene is

$0.17 per gallon. Aviation gasoline tax rate is $0.09 per gallon.

(Round to whole dollars)

10. Tax due is based on the taxable gallons times (X) the appro-

33. Pool bond amount due. From Form 4759, Schedule 5T.

priate tax rates (Line 9 times (X) $0.17 or $0.09).

34. Total remittance due. Total fuel tax, fees, and pool bond amount

11. If you have a motor fuel tax credit from a previous report, you

due (Total Line 32 plus (+) Line 33).

will receive a letter. Enter the amount of your motor fuel tax

The total of fuel tax, aviation gasoline fuel tax, inspection fee,

credit and attach a copy of the authorization.

transport load fee, and pool bond amount should equal Line 34.

12. Total motor fuel tax due (Line 10 minus Line 11).

Send your check or money order to the Missouri Depart-

Inspection Fee (Round to whole dollars)

ment of Revenue. You may also charge the balance due to

13. Total gallons subject to inspection fee (From worksheet, Lines

Mastercard, Discover, American Express, or Visa by calling toll-free

5, 6, 17, and 17A).

( 8 8 8 )

9 2 9 - 0 5 1 3

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(09-2011)

Form 4757 - Distributor'S Monthly Tax Report Page 3

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