Statement Of Gross Sales - Alabama Department Of Revenue
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This space for office use.
LABAMA
EPARTMENT OF
EVENUE
Statement of Gross Sales
RESET
of Illuminating, Lubricating, or Fuel Oils in the State of Alabama
SUBT: SGS
For the Period October 1, 2011 through September 30, 2012
(9/12)
_________________________________________________________________
CN ________________________________________
NAME
(For office use only)
_________________________________________________________________
Phone Number ( ________ ) ___________________
ADDRESS
_________________________________________________________________
E-Mail Address ______________________________
CITY
STATE
ZIP
FEIN ______________________________ SSN _________________________
Alabama Motor Fuels License Number
Check here if new address
Check here for EFT payment
(All blocks must be completed.)
GROSS SALES:
1
$
1. Kerosene and Illuminating Oils . . . . . . . . . . . . . . . . . .
Only the initial wholesale transaction
should be included in the gross sales
2
$
2. Lubricating Oils, Greases, or Substitutes . . . . . . . . .
computation.
3
$
3. Fuel Oils . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The Alabama inspection fees and the
4
$
aboveground and underground storage
4. Tractor Fuels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
tank charge are to be included in the
5
$
gross sales amount.
5. Total Gross Sales . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
X
.005
License Rate: 1/2% of Gross Sales . . . . . . . . . . . . . .
State sales tax, federal, state, and local
excise taxes, exchange transactions,
6
$
6. License Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
sales to the ultimate consumer, and
sales of diesel fuel upon which the state
7
$
7. Failure to Timely File Penalty . . . . . . . . . . . . . . . . . . .
excise tax has been collected should
not be included in the gross sales
8
$
amount. (See explanation on back of
8. Failure to Timely Pay Penalty . . . . . . . . . . . . . . . . . . .
form.)
9
$
9. Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
THIS RETURN IS DUE BY
10
$
10. Total Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
OCTOBER 15, 2012
11
$
11. Amount Remitted . . . . . . . . . . . . . . . . . . . . . . . . . . . .
AFFIDAVIT MUST BE EXECUTED
UNDER PENALTIES OF PERJURY, I declare that I have examined this return and accompanying schedules and statements and, to the best of my knowledge
and belief, they are true, correct, and complete.
Affiant Signature __________________________________________________________ Title ________________________________ Date _________________
Subscribed and sworn to before me on this the ________ day of ______________________, ___________
Signature of Notary Public ________________________________________________________ My commission expires _____________________, ___________
Make check payable to: Alabama Department of Revenue
Mail to: Alabama Department of Revenue
(Form MFT-V must be submitted with payment, unless payment is made electronically.)
Motor Fuels Section
P.O. Box 327540
Montgomery, AL 36132-7540
Telephone Number: (334) 242-9608
Fax Number: (334) 242-1199
Web site:
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