Fillable Form Org-1 - Organic Oil Motor Fuel Tax Return printable pdf download

Form Org-1 - Organic Oil Motor Fuel Tax Return

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Organic Oil Motor Fuel Tax Return

ORG-1

For the period of

through

Check if amended:

Name

Minnesota tax ID or Social Security number

Street address

Check if new address

City

State

Zip code

1 Number of gallons of organic oils or other biological materials

used or sold as motor fuel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

2 Tax rate (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

3 Tax Due (multiply line 1 by line 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

I declare that this return is correct and complete to the best of my knowledge and belief. I confess judgment to the state of Minnesota for the amount

of tax shown due to the extent not timely paid.

Authorized signature

Date

Title

Daytime phone

Make check payable to Minnesota Revenue

Mail to: Minnesota Revenue, Petroleum Taxes, Mail Station 1510, St . Paul, MN 55146-1510

Phone: 651-296-0889 (TTY: Call 711 for Minnesota Relay) . Email: petroleum .tax@state .mn .us

(Rev . 3/13)