Form 577 (700-LPG) "Dealer's Liquid Petroleum Gas Tax Return" - Michigan

What Is Form 577 (700-LPG)?

This is a legal form that was released by the Michigan Department of Treasury - a government authority operating within Michigan. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 2012;
  • The latest edition provided by the Michigan Department of Treasury;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 577 (700-LPG) by clicking the link below or browse more documents and templates provided by the Michigan Department of Treasury.

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Download Form 577 (700-LPG) "Dealer's Liquid Petroleum Gas Tax Return" - Michigan

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Michigan Department of Treasury
700-LPG
577 (Rev. 09-12)
Reset Form
This form is issued under authority of P.A. 403 of 2000, as amended. Filing is Mandatory.
Dealer’s Liquid Petroleum Gas Tax Return
2. Report Period (MM/CCYY)
This report is due
3. Account Number (FEIN or TR)
3A. License Number
1. Company Name and Mailing Address
4. Contact Person Name
5. Telephone Number
6. Fax Number
7. E-mail Address
INSTRUCTIONS: All licensed LPG dealers must file this report with remittance on or before the 20th day of the month following the end
of the reporting period. Please only report whole gallons. File even if no tax is due. Failure to file is punishable by penalty, interest and
revocation of your license. Complete all applicable items.
DIRECT SALES OR DELIVERY TO MOTOR VEHICLES
8. L.P. gas sold or delivered by placing into a permanently attached fuel supply
tank of a motor vehicle .................................................................................................
8. __________________
9. L.P. gas sold or delivered by exchanging or replacing the fuel supply tank
of a motor vehicle ........................................................................................................
9. __________________
SALES TO STORAGE FACILITIES
10. L.P. gas delivered into a storage facility used exclusively for resale to or for
use by motor vehicles ..................................................................................................
10. __________________
COMPANY USE
11. L.P. gas withdrawn from cargo container of truck, trailer or semi-trailer for
operation of motor vehicles ..........................................................................................
11. __________________
12. L.P. gas delivered to company-owned motor vehicles .................................................
12. __________________
You must complete lines 13 through 17.
13. Gross taxable gallons. Add lines 8 through 12 .............................................................................................................
13. ____________________
TAX COMPUTATION
$
14. Tax due at 15 cents per gallon (line 13 x .15) ...............................................................................................................
14. ____________________
$
15. Penalty (5% of tax due per month to a maximum of 25%.) ..........................................................................................
15. ____________________
$
16. Interest (1% above prime rate set January 1 and July 1 of each year) ........................................................................
16. ____________________
$
17. TOTAL REMITTANCE. Add lines 14 through 16 ...................................................................................................PAY
17. ____________________
CERTIFICATION
I certify under penalty of perjury, that I have examined this return, and to the best of my knowledge and belief, it is true and complete.
I authorize Treasury to discuss my return and attachments with my preparer.
Do not discuss my return with my preparer.
Authorized Signature
Preparer’s Signature
Preparer’s FEIN
Printed Name
Date
Printed Name
Date
Title
Address
Telephone Number
Telephone Number
(
)
(
)
Make check payable to “State of Michigan-Motor Fuel.”
MAIL ZERO RETURN TO:
Print your account number on the front of your check.
Michigan Department of Treasury
Special Taxes Division - Motor Fuel
MAIL WITH REMITTANCE TO:
P.O. Box 30474
Michigan Department of Treasury
Lansing, Michigan 48909-7974
P.O. Box 77401
Questions??? Call (517) 636-4600
Detroit, Michigan 48278
www.michigan.gov/treasury
Michigan Department of Treasury
700-LPG
577 (Rev. 09-12)
Reset Form
This form is issued under authority of P.A. 403 of 2000, as amended. Filing is Mandatory.
Dealer’s Liquid Petroleum Gas Tax Return
2. Report Period (MM/CCYY)
This report is due
3. Account Number (FEIN or TR)
3A. License Number
1. Company Name and Mailing Address
4. Contact Person Name
5. Telephone Number
6. Fax Number
7. E-mail Address
INSTRUCTIONS: All licensed LPG dealers must file this report with remittance on or before the 20th day of the month following the end
of the reporting period. Please only report whole gallons. File even if no tax is due. Failure to file is punishable by penalty, interest and
revocation of your license. Complete all applicable items.
DIRECT SALES OR DELIVERY TO MOTOR VEHICLES
8. L.P. gas sold or delivered by placing into a permanently attached fuel supply
tank of a motor vehicle .................................................................................................
8. __________________
9. L.P. gas sold or delivered by exchanging or replacing the fuel supply tank
of a motor vehicle ........................................................................................................
9. __________________
SALES TO STORAGE FACILITIES
10. L.P. gas delivered into a storage facility used exclusively for resale to or for
use by motor vehicles ..................................................................................................
10. __________________
COMPANY USE
11. L.P. gas withdrawn from cargo container of truck, trailer or semi-trailer for
operation of motor vehicles ..........................................................................................
11. __________________
12. L.P. gas delivered to company-owned motor vehicles .................................................
12. __________________
You must complete lines 13 through 17.
13. Gross taxable gallons. Add lines 8 through 12 .............................................................................................................
13. ____________________
TAX COMPUTATION
$
14. Tax due at 15 cents per gallon (line 13 x .15) ...............................................................................................................
14. ____________________
$
15. Penalty (5% of tax due per month to a maximum of 25%.) ..........................................................................................
15. ____________________
$
16. Interest (1% above prime rate set January 1 and July 1 of each year) ........................................................................
16. ____________________
$
17. TOTAL REMITTANCE. Add lines 14 through 16 ...................................................................................................PAY
17. ____________________
CERTIFICATION
I certify under penalty of perjury, that I have examined this return, and to the best of my knowledge and belief, it is true and complete.
I authorize Treasury to discuss my return and attachments with my preparer.
Do not discuss my return with my preparer.
Authorized Signature
Preparer’s Signature
Preparer’s FEIN
Printed Name
Date
Printed Name
Date
Title
Address
Telephone Number
Telephone Number
(
)
(
)
Make check payable to “State of Michigan-Motor Fuel.”
MAIL ZERO RETURN TO:
Print your account number on the front of your check.
Michigan Department of Treasury
Special Taxes Division - Motor Fuel
MAIL WITH REMITTANCE TO:
P.O. Box 30474
Michigan Department of Treasury
Lansing, Michigan 48909-7974
P.O. Box 77401
Questions??? Call (517) 636-4600
Detroit, Michigan 48278
www.michigan.gov/treasury