Form Dr-189 Draft - Application For Fuel Tax Refund Municipalities, Counties And School Districts Page 2
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1
2
3Important Information Concerning Application for Fuel Tax
Refund
DR-189
Municipalities, Counties and School Districts
R. 01/18
A Power of Attorney, Florida Department of Revenue Form DR-835,
Page 2
must be properly executed and included if this application is prepared by your representative.
1.
Permit holders are entitled to a refund of the fuel sales
employee identification number of the seller.
tax levied under ss. 206.41 (1)(b)and(g) and 206.87(1)(a)
C. Type of motor fuel you purchased using the product
and(e) of Chapter 206, F.S., on gasoline, gasohol and diesel
types listed at the top of the schedules.
fuel purchased. The applicable tax rates are entered by
the Department and are published annually in Taxpayer
D. Sales invoice number.
Information Publications on the Department's website at:
E. Date that you took possession of the motor fuel from
the supplier (must be within this calendar quarter).
2.
Applications are to be used only for the quarter indicated
F. County in which you took possession of the motor fuel
on the face of this application. Only original refund
from the supplier.
applications are acceptable. Application forms may be
requested from the Department of Revenue, Refunds.
G. Total price you paid for the motor fuel purchased.
3.
Refund permits are renewed on an annual basis only if the
H. Number of gallons of motor fuel you purchased.
permit holder files quarterly claims during the year.
7.
In the event of overpayment of any refund, the
4.
Applications must be filed quarterly, no later than the last
Department of Revenue will refuse to make further
day of the month immediately following the quarter. The
refunds and advise the payee of the amount to be
filing date may be extended one additional month only if
reimbursed.
a justified, written excuse is submitted with the claim and
8. Gallons that you purchased during the previous year and
only if the prior quarter’s claim was filed on time.
consumed during the current quarter will not be eligible
Purchases Made
Claims Must Be
With A Written
for the full refundable rate for the current year. Instead,
During
Filed By *
Excuse -
these gallons should be multiplied by last year’s rate. This
No Later Than
adjustment will compensate for any inventory that was
assessed at last year’s rate and carried forward to the
January, February,
April 30
May 31
and March
current calendar year.
April, May, and
July 31
August 31
June
Line-by-Line Instructions
July, August, and
October 31
November 30
September
Purchases of Gasoline, Gasohol, and Undyed Diesel Fuel
October, November,
January 31
February 28
and December
Line 1.
Beginning Inventory – Must be the same as your
*Amended application for prior quarter must be received by
closing inventory from prior quarter. If the prior
current quarter’s deadline. Example: You must submit an
quarter’s claim was not filed, enter zero.
amended March quarterly application by July 31.
Line 2.
Gallons Purchased – This represents fuel you
5.
Each permit holder must maintain records to substantiate:
purchased during the calendar quarter. These
• Fuel was used by a qualified applicant
purchases must be supported by the Schedule
• Fuel taxes were paid on the refundable gallons
of Purchases (Page 3).
• Gallons reported as Beginning and Ending Inventory
Line 3.
Closing Inventory – Actual physical inventory as
• Fuel was used in an eligible manner
of the last day of the quarter printed on Page 1.
When copies of your records are required to determine
This will be your beginning inventory for the
the amount of refund due, the Department will issue a
next quarter. If no refund is due but a closing
written request to you within 30 days of the receipt of
inventory exists, the claim form must be filed.
your application. Your application for a refund is not
Line 4.
Total consumption – Line 1 plus Line 2 minus
complete until the requested records are received by the
Line 3.
Department.
Line 5.
Gallons not claimed for refund – This represents
6.
The Schedule of Purchases (Page 3), detailing the
fuel purchased which was not used
information listed below, may be submitted instead of
in motor vehicles (used for “off road”
original invoices. Include only one product type listed at
purposes).
the top of the Schedule of Purchases. Separate schedules
Line 6.
Gallons claimed for refund – This
must be used for each product type. However, first time
represents fuel used in a motor vehicle
filers of this form must submit tax paid invoices with their
operated by the permit holder.
initial refund request.
A. Name and address of supplier that you purchased
motor fuel from.
B. Department of Environmental Protection storage tank
facility identification number of the tank where the
motor fuel was stored prior to purchase or the federal
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