Fillable Form Pdr-1p - Minnesota Motor Vehicle Fuel Report

Form Pdr-1p - Minnesota Motor Vehicle Fuel Report - 2013

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PDR-1P

2013 Minnesota Motor Vehicle Fuel Report

Complete this form if you used tax-free fuel that was dispensed from an on-farm storage tank into a licensed highway vehicle or if you did not

pay tax on ethyl alcohol you produced for use in a licensed vehicle . Report all fuel/ethyl alcohol used in the previous year .

File this form and pay the tax due by March 15, 2014 .

Check if amended:

Name

Daytime phone

For period

through

calendar year

Address

Check if new address

Enter Minnesota tax ID number (if a business)

or Social Security number (if an individual)

City

State

Zip code

1 Number of gallons of tax-free fuel used in a licensed motor vehicle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

.285

2 Tax rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

3 Amount due (multiply line 1 by line 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

4 Total for the year (add amounts on line 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Make check payable to

Minnesota Revenue

I declare that this return is correct and complete to the best of my knowledge and belief.

Authorized signature

Title

Date

Daytime phone

Mail your Form PDR-1P and check to:

Minnesota Revenue, Petroleum Taxes, Mail Station 4108, St . Paul, MN 55146-4108 .

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

(Rev . 03/13)