Form Dr-309631 Draft - Terminal Supplier Fuel Tax Return

Form Dr-309631 Draft - Terminal Supplier Fuel Tax Return - 2018 Page 3

00002

DR-309631

Mail To:

Terminal Supplier

Florida Department of Revenue

R. 01/14

Fuel Tax Return

5050 W Tennessee St

Page 3

Tallahassee FL 32399-0165

2018

For Calendar Year

Check here if filing a supplemental return

FEIN:

920002018999900910270315300000000100002

License Number:

Collection Period Ending:

DOR USE ONLY

POSTMARK OR HAND-DELIVERY DATE

Return Due By

Late After

Complete Reverse Side of Return First

26.

Combined gasoline, diesel and aviation fuel tax due: (Page 4, Line 26) ........................................26. _________________________

CREDITS

27.

Ultimate vendor credits:

From ultimate vendor credit worksheet (Page 13, Line 25) ............27. _________________________

28.

Credit memos issued by the Department of Revenue: ...................28. _________________________

29.

Other allowed credits: (Page 17, Line 15) .......................................29. _________________________

TOTAL DUE WITH RETURN CALCULATION

30.

Tax due with return: (Line 26 minus Lines 27 through 29) ..............................................................30. _________________________

31.

Penalty: ...........................................................................................................................................31. _________________________

32.

Interest: ...........................................................................................................................................32. _________________________

33.

Total due with return: (Line 30 plus Line 31 plus Line 32) ...............................................................33. _________________________

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