Form Ifta-1 - International Fuel Tax Agreement (Ifta) License Application

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State of Rhode Island
Division of Taxation
One Capitol Hill
Providence, RI 02908-5800
International Fuel Tax Agreement (IFTA)
License Application
Registration Period 1/1/2012 through 12/31/2012
Type or Print
Federal Employer Identification # or Social Security #
Business telephone #
Legal name
Business name (if different from above)
Physical address
City
State
Zip Code
Mailing Address (include apt., office or unit #, if any)
City
State
Zip Code
Provide a name and telephone number to contact,
Name
if additional information is needed, regarding
IFTA Quarterly Tax reporting.
(
)
Telephone number
Date you began or will begin IFTA in Rhode Island
Were you previously registered in IFTA with another jurisdiction?
If yes, where?
USDOT Number:
International Registration Plan ( IRP ) registration number:
Type of business
Individual
Corporation
Partnership
Other (specify)
Names, titles, social security numbers and residence addresses of principal officers of corporation or of members, partners, owners, etc.
Name
Title
Social Security #
Number & Street
City or Town, State, Zip Code
Decal Order and Application Fee
One who is applying for Fuel Use Tax registration for the first time will be required to pay both a ten dollar ($10.00) IFTA License Application fee and a
2012 IFTA decal fee of ten dollars ($10.00) per vehicle.
Indicate the number of IFTA vehicles on this line
You will be issued two IFTA decals for each vehicle.
License fee $
Decal fee $
Number of IFTA vehicles X $10.00 per vehicle
Total Due $
Remit fees with application.
Make check payable to: Rhode Island Division of Taxation
Complete items on reverse and be sure to sign this application.
IFTA-1 12/2010

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