West Virginia State Tax Department - Motor Fuel Excise Tax

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WEST VIRGINIA STATE TAX DEPARTMENT
WV/MFR-14 Retail Evaporation
Tax Account Administration Division, Excise and Support Unit
REV 07/11
P.O. Box 2991
Charleston, WV 25330-2991
MOTOR FUEL EXCISE TAX
Schedule E - Retail Evaporation
8-Digit Acct No. or FEIN:
Period Ending:
SECTION 1. GAIN OR LOSS CALCULATION
A
B
C
D
E
F
G
H
I
REPORT IN WHOLE
GASOLINE
GASOHOL
CLEAR DIESEL
COMPRESSED
DYED
CLEAR
DYED
PROPANE
TOTAL
GALLONS
065
124
160
NATURAL GAS
DIESEL
KEROSENE
KEROSENE
054
(ADD COLUMNS A
224
228
142
072
THRU H AND
ENTER TOTAL FOR
EACH LINE)
1. OPENING INVENTORY
ST
(MEASURED JULY 1
)
2. RECEIPTS
3 TOTAL (LINE 1 PLUS LINE 2)
4 CLOSING INVENTORY
TH
(MEASURED JUNE 30
)
5. TOTAL TO ACCOUNT FOR
XXXXXXXXX
XXXXXXXXXXXXX
(LINE 3 MINUS LINE 4)
ON ROAD USE
ON ROAD USE
6. METERED SALES
XXXXXXXXX
XXXXXXXXXXXXX
(July 1- June 30) WV TAX
COLLECTED
7. GAIN (IF LINE 6 GREATER
XXXXXXXXX
XXXXXXXXXXXXX
THAN LINE 5)
8. LOSS (IF LINE 6 IS LESS
XXXXXXXXX
XXXXXXXXXXXXX
THAN LINE 5)
SECTION 2. REFUND OR TAX DUE CALULATION
Note: If your supplier has title to the petroleum product until it is a meter sale, you are not eligible
1. GAIN (ENTER GALLONS FROM SECTION 1, COLUMN I, LINE 7)
for an evaporation refund.
2. AMOUNT DUE (SECTION 2, LINE 1 X CURRENT TAX RATE)
NAME OF SUPPLIER(S):
3. LOSS ( ENTER GALLONS FROM SECTION 1, COLUMN I, LINE 8)
IS PETROLEUM PRODUCT PAID FOR AT TIME OF PURCHASE?
4. REFUND DUE FROM LOSS
(SECTION 2, LINE 3 X .205)
NOT TO EXCEED ONE HALF OF ONE
YES___
NO___
PERCENT SECTION 1, LINE 5 MULTIPLIED BY THE CURRENT TAX RATE
5. TOTAL REFUND DUE/ TOTAL TAX DUE
$
Enter Amount in Section 5 on the back of Refund
(SECTION 2, LINE 4, MINUS LINE 2) If
line 2
Application (MFR-14)
is greater than Line 4 enter total tax due and enclose
payment.

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