Aviation Fuel Excise Tax Application Page 2
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4Section B: Signature Section
This section must be completed by all applicants.
I do hereby certify under penalty of perjury that the foregoing and attached information is true and correct to the best of my knowledge
and is a complete and full representation based upon the best information available.
Signature: _____________________________________ Title: ___________________________ Date: ____________________
Telephone number: ______________________________ Email: _____________________________________
This application must be signed by the owner, general partner, corporate officer, or resident agent before it will be accepted by
the department. (IC 6-8.1-3-4)
The partners or corporate officers are each personally, jointly, and severally liable for the Aviation Fuel Excise Tax
collected and withheld. These taxes are trust fund taxes and are not discharged in bankruptcy proceedings.
Mail to:
Fax: (317) 615-2691
Indiana Department of Revenue
Email:
fetax@dor.in.gov
Fuel Tax, Bonds, and Licensing Section
P. O. Box 6114
Indianapolis, IN 46206-6114
Instructions for Aviation Fuel Excise Tax Application
General Information
Section A:
Taxpayer Information
Form AV-1 is the license application to be used when registering
with the Indiana Department of Revenue, Fuel Tax Section, for
All applicants must complete this section. The information
the aviation fuel excise tax. The aviation fuel excise tax becomes
requested is general taxpayer information. All requested
effective on July 1, 2013, per IC 6-6-13. A retailer who engages in
information must be supplied.
the business of selling or distributing aviation fuel to the end user
within Indiana is required to collect the $ .10 per gallon aviation
1.
Owner Name, Legal Partnership Name, Corporate Name,
fuel excise tax.
or Other Entity Name. If you are a sole proprietor, enter
your last name, first name, and middle initial. If you are a
A license holder must file a monthly Aviation Fuel Excise Tax
corporation, enter your corporate name as listed on your
Return Form AVF-150 using the department’s online tax filing
corporate charter. If you are a partnership and have a legal
program INtax. Visit A return must be filed every
partnership name, enter the name as recognized by the
month even if no tax is due. The return and payment are due the
Internal Revenue Service. All government agencies should
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of the month following the reporting period.
th
list their proper agency names.
Retailers licensed to collect the aviation fuel excise tax are
2.
Federal Employer Identification Number. Enter your
required to remit taxes due to the department by electronic funds
federal employer identification number. According to federal
transfer (EFT).
guidelines, most partnerships and all corporations are
required to obtain a federal employer identification number.
Important:
This number is also required whenever you withhold federal
•
All applicable questions must be answered. Failure to do
income tax from employees, regardless of ownership type. If
so will result in a delay in processing and/or issuing your
you have applied for a federal employer identification number
license(s).
but have not yet received one, indicate “applied for” on this
line. You may get this number by completing the Internal
•
Please print legibly or type the information on your
Revenue Service Form SS-4. The Internal Revenue Service
application.
assigns your federal employer identification number to you.
•
Any outstanding tax liabilities owed by the applicant or an
3.
Business Trade Name. If you operate your business using a
owner, a partner, or an officer will delay application approval.
trade or d/b/a name, enter that name.
•
To complete the license application, follow the section-by-
4.
Contact Person. Enter the name of a person within your
section instructions.
organization whom the Indiana Department of Revenue may
contact about fuel tax-related matters.
5.
Business Location. Indicate the actual location of your
business by providing the street address, city, state, Zip
Code, and county. Note: A post office box is not acceptable
as a business location address.
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