Form Sft-4 - User-Seller'S Special Fuels Tax Return

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Massachusetts Department of Revenue
SFT-4
Rev. 5/02
User–Seller’s Special Fuels Tax Return
Return must be filed no later than the 20th day of the month following that for which the return is made. Purchases of special fuels must be made
only from a licensed supplier whose name is included on the list furnished to you. A complete and accurate record of all purchases and sales of
special fuels must be kept. Mail this completed return to: Massachusetts Department of Revenue, PO Box 7012, Boston, MA 02204.
Month
Year
Federal Identification number
Name of user – seller
Telephone
Street address
City/Town
State
Zip
The undersigned user – seller states under the penalties of perjury that all of the information contained in this return and in all schedules
attached hereto is complete, true and accurate in every particular.
Authorized signature
Title
Date

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