Form 3161 - Motor Carrier Diesel Fuel Tax Report

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Michigan Department of Treasury
3161 (Rev. 3-03)
MC-L
MOTOR CARRIER DIESEL FUEL TAX REPORT
Issued under P.A. 119 of 1980. Filing is mandatory.
4
1. Do you maintain diesel fuel
storage in Michigan?
YES
NO
4
4
4
3. Account No. (FE, ME or TR)
4. Report for calendar quarter
2. Name, DBA, Address (City, State, ZIP)
4
5.
6. Check here if no miles this quarter
Cancel license (
Enter effective
date for cancellation below.)
7. Telephone number between
4
8 a.m. - 5 p.m.
(Mo./Day/Yr.)
(
)
8.
Total Michigan miles for decaled vehicles ......................................................................................
4
8.
9.
Gallons consumed in non-qualifying (non-decaled ) vehicles .....................................................
4
9.
TAX:
10.
Tax paid diesel gallons purchased at retail fuel stations into
4
4
decaled vehicles only ..........................................................
_______________ gallons x .06 =
$
10.
If you do not have diesel fuel storage, non-qualifying vehicles, non-highway equipment, or tax free purchases, skip to line 23 and enter the
amount from line 10 on line 23. Complete lines 21 and 22 only if you are filing late.
11.
Tax paid diesel fuel purchased at retail fuel stations into
4
4
non-qualifying (non-decaled) highway vehicles................
_______________ gallons x .06 =
11.
$
4
4
12.
Tax paid diesel gallons purchased into storage ...................
_______________ gallons x .06 =
$
12.
13.
Tax free diesel fuel used in decaled and non-qualifying
4
4
(non-decaled) vehicles (see instructions).............................
_______________ gallons x .15 =
13.
$
14.
Total Tax. Add lines 10 through 13 .................................................................................................
14.
$
CREDITS:
15.
Tax paid diesel fuel storage withdrawals into off-road
4
4
equipment...........................................................................
_______________ gallons x .15 =
15.
$
16.
Tax paid diesel fuel purchased at retail fuel stations into
4
4
off-road equipment..............................................................
_______________ gallons x .09 =
$
16.
17.
Purchases where 15 cent diesel tax rate was paid. To receive
credit you must attach copies of invoices dated during the
4
calendar quarter which show the 15 cent tax rate...........
_______________ gallons x .06 =
4
$
17.
18.
Credits: Add lines 15, 16 and 17 .....................................................................................................
18.
$
4
19.
Refund: If line 14 is less than line 18, subtract line 14 from line 18. Enter amount here. REFUND
19.
$
20.
Net Tax Due: If line 14 is more than line 18, subtract line 18 from line 14.
4
Enter amount here................................................................................................... NET TAX DUE
$
20.
21.
Penalty: (See instructions for line 21) .............................................................................................
21.
$
22.
Interest: (See instructions for line 22). Current daily rate is
$
22.
PAY
4
23.
Net Tax, Penalty and Interest Due: Add lines 20, 21 and 22................................................
$
23.
CERTIFICATION
I certify, under penalty of perjury, that I have read this report and attachments and that it is true and complete to the best of my knowledge.
The preparer's signature (if applicable) is based on all information of which that preparer had knowledge.
I authorize Treasury to discuss my report and attachments with my preparer.
Do not discuss my report with my preparer
Date
Preparer's Signature, Address, Telephone Number
Taxpayer's Signature
Title
4
Preparer's Federal ID or Social Security Number
Make check payable to 'State of Michigan-MC.' Write your account number on your check. Mail this report and your payment to:
Dept. 77833, Michigan Motor Carrier Tax, P.O. Box 77000, Detroit, MI 48277-0833. If you have any questions call the Customer Contact
Division - Special Taxes at (517) 636-4580. Deaf, hearing or speech impaired persons call (517) 636-4999 (TTY).

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