Form Dr-309632 Draft - Wholesaler/importer Fuel Tax Return

Form Dr-309632 Draft - Wholesaler/importer Fuel Tax Return - 2018 Page 3

00002

DR-309632

Mail To:

Wholesaler/Importer

Florida Department of Revenue

R. 01/14

5050 W Tennessee St

Fuel Tax Return

Page 3

Tallahassee FL 32399-0165

2018

For Calendar Year:

Check here if filing a supplemental return

FEIN:

920002018999900920270323300000000100002

License Number:

Collection Period Ending:

DOR USE ONLY

POSTMARK OR HAND-DELIVERY DATE

Return Due By

Late After

Complete Reverse Side of Return First

24.

Combined gasoline, diesel, and aviation fuel tax due: (Page 4, Line 24) ................................................ 24. _________________________

CREDITS

25.

Ultimate vendor credits: From ultimate vendor credit worksheet (Page 13, Line 25) ........... 25. _______________________

26.

Credit memos issued by the Department of Revenue: ......................................................... 26. _______________________

TOTAL DUE WITH RETURN CALCULATION

27.

Tax due with return: (Line 24 minus Lines 25 and 26) ............................................................................. 27. _________________________

28.

Penalty: .................................................................................................................................................... 28. _________________________

29.

Interest: .................................................................................................................................................... 29. _________________________

30.

Total due with return: (Line 27 plus Line 28 plus Line 29) ........................................................................ 30. _________________________

Check here if you have electronically transmitted funds

Under penalty of perjury, I declare that I have read this return and the facts stated in it are true.

_______________________________________________________________________________________________________________________

Signature of Officer/Owner

Title

Date

_______________________________________________________________________________________________________________________

Name of Preparer (Print)

Signature of Preparer

Telephone Number

FEIN

Date