Form Gas - Gasoline Distributor Tax Return - Maine Revenue Services Page 2
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1
2Maine Revenue Services
00
Gasoline Distributor Tax Return
Page 2
*0708001*
Make check or money order payable to the STATE TREASURER and send your remittance with your return postmarked by
the due date printed on the top of the return. Please record your registration number on your check. Failure to file a return on
or before the due date will result in interest and penalty charges. Billings will be issued shortly after the processing of your
return. A return must be filed even if there were no sales or purchases during the period.
Tax Computation
Gallons
Tax
,
,
,
,
.
@ $.276
Taxable Sales of Gasoline
Sch 5
9.
,
,
,
,
.
@ $.276
Taxable Sales of Aviation Gas
Sch 5
10.
,
,
,
,
.
@ $.034
Taxable Sales of Jet Fuel
Sch 5
11.
,
,
Total Taxable Gallons Sold
(must equal line 8)
12.
,
,
.
Net Excise Tax Due
(total lines 9, 10 and 11)
13.
,
,
.
Dealer Credit Card Sales to U.S. Government
Sch 22
14.
,
,
.
Excise Tax Paid Purchases
Sch 1
15.
,
,
.
Credit from Prior Period
16.
,
,
.
Amount Due
Line 13 less lines 14, 15 and 16. Use line 18 if result is a credit.
17.
Must equal lines 19+20+21
,
,
.
Credit Due
If line 13 minus lines 14, 15 and 16 is a credit, enter the amount to the right.
18.
Must equal lines 19+20+21.
If you wish a refund rather than a carry forward to the next period, check here.
,
,
.
Net Excise Tax - Gasoline
19.
,
,
.
Net Excise Tax - Aviation Fuel
20.
,
,
.
Net Excise Tax - Jet Fuel
21.
The following are attached to this return to support one or more of the above schedules:
Receipts
Sch.1
Disbursements
Sch. 5
/
Mail To:
Sch. 2
Sch. 6
Maine Revenue Service
P.O. Box 1064
Sch. 3
Sch. 7
Augusta, ME 04332-1064
Sch. 4
Sch. 8
Sch. 9
Sch. 10
Credits
Sch. 22
Print Name
Signature/Title
Date
Phone #
GT-5 Revised 07/07
For assistance in completing this form, call (207) 624-9609
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