Form Tc-922c - Refund Of Tax Reported On Exempt Fuel For Non-Utah Based Carriers - 2008

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Utah State Tax Commission
TC-922C
92285
Refund Of Tax Reported On Exempt
Rev. 12/08
Fuel For Non-Utah Based Carriers
Refund application may only be filed on a quarterly basis.
9998
FEIN or SSN
Name of entity requesting refund
C
Mailing address (where refund is sent)
SP
Check box if this is a SSN
Filing period (mmddyyyy)
City, State, ZIP code
From:
To:
Part A: From PTO Gallons Consumed (See Instructions)
1. Enter gallons dispensed into cement trucks in Utah
1
2.
Cement truck exempt gallons
in Utah
(multiply line 1 by .20)
2
3
3. Enter gallons dispensed into trash compaction vehicles
4
4. Trash compaction vehicle exempt gallons (multiply line 3 by .20)
5
5. Enter the number of pounds of dry product loaded/off loaded in Utah
6. Divide line 5 by 6,000
6
7. Enter exemption allowance (see instructions)
7
8
8. Dry product loaded/off loaded PTO exempt gallons (multiply line 6 by line 7)
9
9. Enter the number of gallons of liquid product loaded/off loaded in Utah
10
10. Divide line 9 by 1,000
11. Enter exemption allowance (see instructions)
11
12
12. Enter liquid product loaded/off loaded PTO exempt gallons (multiply line 10 by line 11)
13
13. Other Utah PTO gallons claimed (attach explanation if claiming an amount other than that allowed above)
14. TOTAL PTO gallons (add lines 2, 4, 8, 12 and 13)
14
Part B: MPG Excluding PTO Activities and Refundable PTO Gallons
15
15. Enter total miles reported on the IFTA return
16
16. Enter total fuel consumed shown on the IFTA return
17. Utah PTO gallons consumed (from line 14)
17
18. PTO gallons consumed from operations in
other states
(see instructions)
18
19. Total PTO gallons consumed (add line 17 and line 18)
19
20. Non-PTO gallons consumed (subtract line 19 from line 16)
20
21. Miles Per Gallon (MPG) exclusive of PTOs (divide line 15 by line 20)
21
22. Taxable Utah miles per the IFTA tax return
22
23. Taxable Utah fuel (divide line 22 by line 21)
23
24. Total Utah fuel (add line 17 to line 23)
24
25. Utah taxable gallons reported on the IFTA tax return
25
26. Subtract line 25 from line 24 (enter zero if result is negative)
26
27. Refundable PTO gallons consumed (subtract line 26 from line 17)
27
PART C: Undyed Diesel Fuel Used Other Than In Motor Vehicle Engines In Utah
Undyed diesel fuel purchased in Utah and dispensed into the secondary fuel tank of the vehicle
28
28.
when the fuel is used to operate a secondary device and is not used to propel the vehicle
29
Undyed diesel fuel purchased in Utah and dispensed into machinery/equipment not registered and
29.
not required to be registered for highway use.
30
30. Refundable non-highway gallons (add lines 28 and 29 and enter here and on line 32)
PART D: Summary
Total exempt PTO gallons subject to refund (Enter the amount on line 27. If you did not complete
31
31.
PART B, enter the amount from line 14. If you did not complete PARTS A or B, enter ZERO.)
32
32. Enter qualifying exempt gallons from line 30
33. Total refundable exempt gallons (add lines 31 and 32)
33
34. Total refundable amount (multiply line 33 by the Utah fuel tax rate)
34
35. Sales tax due on exempt fuel (see instructions) Enter average tax-free price ____________.
35
36. Total Refunds (subtract line 35 from line 34) NOTE: Signature is required for all refunds
36
I certify under penalties of perjury, this report is true, correct, and complete to the best of my knowledge.
Telephone number
Signature
Date signed
Print name of person signing this form

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