Form 84ag - Nebraska Ag Use Motor Fuels Tax Refund Claim Page 2
Download a blank fillable Form 84ag - Nebraska Ag Use Motor Fuels Tax Refund Claim in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 84ag - Nebraska Ag Use Motor Fuels Tax Refund Claim with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3INSTRUCTIONS
CAUTION: Only federal governmental agencies and buses for hire are eligible for the refund of tax on fuel
placed into a licensed motor vehicle. All other users of fuel in licensed motor vehicles, regardless of how
those vehicles are used, are not eligible for a refund of motor fuels tax.
NOTE: All refund claims are subject to audit for three years after the claim is filed.
WHO MAY FILE. Any person requesting a refund of Nebraska motor fuels tax paid on fuel used in unlicensed
equipment for farming or ranching purposes may file a Nebraska Ag Use Motor Fuels Tax Refund Claim,
Form 84AG. Prior to adjustments, the tax paid on the eligible fuel must be at least $25. This minimum must be
met within a calendar year for each fuel type.
WHEN TO FILE. Only one claim per month may be filed by any claimant. You must file your claim within three
years from the date of payment of the tax.
WHERE TO FILE. This claim, along with supporting documentation, must be filed with the Nebraska Department
of Revenue, Motor Fuels Division, PO Box 98904, Lincoln, NE 68509-8904.
BASIS FOR CLAIM. Appropriate documentation must be attached to the Form 84AG. Documentation submitted
with the Form 84AG will not be returned.
Exempt Use of Tax-Paid Undyed Diesel, Gasoline, Gasohol, and Ethanol. Any person who
has purchased and used tax-paid fuel for a qualified exempt purpose may file a claim.
Required Documentation. In order to support the claim, the following information must be included:
•
A description of your operations must be submitted with the initial claim, and then
on an annual basis; include the number of acres farmed, types of crops raised, and
the number and type of livestock;
•
A list of the type of equipment in which the fuel was used must be submitted with the
initial claim, and then on an annual basis; include the make, horsepower, and other
mechanical description of the machinery;
•
Information regarding the fuel purchase usage and storage;
•
Legible copies of fuel purchase invoices indicating the amount of tax paid, the date
of purchase, fuel type, gallons purchased, and vendor’s name. If the fuel was placed
directly into unlicensed equipment, the equipment fueled must be indicated on the
invoice; and
•
Legible copies of withdrawal logs documenting the date, gallons, and equipment into
which the fuel was placed if both licensed vehicles and unlicensed equipment are
Nebraska Motor Fuels Tax Refunds
fueled from the same storage facility (refer to the
Information Guide
for additional information).
If your documentation exceeds the Form 84AG space limitations, you may attach additional sheets of paper.
SPECIFIC INSTRUCTIONS FOR CALCULATING THE REFUND
Multiply the number of gallons claimed by the refund rate in effect when the fuel was purchased and enter the
amount calculated. Round all gallon and dollar amounts from .50 to .99 to the next higher whole number. Round
all gallon and dollar amounts less than .50 to the next lower whole number. If gallons are claimed for periods with
multiple refund rates, attach a summary of these calculations.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Rmft-11-a - Illinois Motor Fuel Tax Refund Claim For Tax Paid On Or After January 1, 2001
Financial
Form L-325 - Application For Motor Fuel Tax Refund On Diesel Fuel Used In Non-highway Equipment
Financial
Related Categories
Parent category: Financial