Form 3712 - Motor Fuel Tax License Application Page 5

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3712, Page 5

Indicate the country and/or province from which you will import, the type of fuel license you hold for that country/province, and the fuel products that you

will import. You must also attach a copy of your license for each jurisdiction.

Products to be imported (see instructions for

Country/Province

License Type

a list of product codes)

PART 9: EXPORTER INFORMATION

If no, skip to Part 10.

50. Will you export fuel products, including biodiesel, from the state of Michigan?

Yes

Indicate the jurisdiction to which you will export, the type of fuel license you hold for that state or country/province, and the fuel products you will

export. You must also attach a copy of your license for each jurisdiction.

Products to be exported (see Form 4667 for a

Country/Province

License Type

list of product codes)

PART 10: BLENDER INFORMATION

Questions 51-54 only pertain to activity below the terminal rack.

51. Will you blend tax-paid fuel products with untaxed products? ...............................

Yes

52. Will you blend ethanol and gasoline to produce a gasoline product? ...................

Yes

53. Will you blend biodiesel and petroleum diesel to produce a diesel product? .......