Form 3715 (200-CCR) "Carrier's Monthly Report: Pipeline, Barge, Marine Vessel" - Michigan

Form 3715 is a Michigan Department of Treasury form also known as the "Form 200-ccr - Carrier's Monthly Report: Pipeline, Barge, Marine Vessel". The latest edition of the form was released in September 1, 2012 and is available for digital filing.

Download an up-to-date fillable Form 3715 in PDF-format down below or look it up on the Michigan Department of Treasury Forms website.

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Download Form 3715 (200-CCR) "Carrier's Monthly Report: Pipeline, Barge, Marine Vessel" - Michigan

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Michigan Department of Treasury
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200-CCR
3715 (Rev. 09-12)
Carrier's Monthly Report: Pipeline, Barge, Marine Vessel
This form is issued under authority of P.A. 403 of 2000, as amended.
This report is due
2. Account Number (FEIN or TR)
2A. License Number
3. Report Period (MM/YYYY)
1. Company Name and Mailing Address
4. Contact Person Name
5. Telephone Number
6. Fax Number
7. E-mail Address
Net Gallons - Report Whole Gallons Only
This report must be filed by all carriers for
Column 6
Column 1
Column 2
Column 3
Column 4
Column 5
shipments into, out of and within the State of
Michigan.
Gasoline
Aviation
Other Products
Jet Fuel
Undyed
Dyed
Gasoline
See page 2 for instructions.
Diesel Fuel
Diesel Fuel
8. Total gallons of petroleum product
transported from Michigan to another state.
Enter total from attached Schedule(s) 14A.
9. Total gallons of petroleum product
transported from out-of-state terminals and
refineries into Michigan. Enter total from
attached Schedule(s) 14B.
10. Total gallons of petroleum product
transported from Michigan terminals and
refineries to locations elsewhere in
Michigan. Enter total from attached
Schedule(s) 14C.
11. Total gallons of petroleum product
transported. Add lines 8 through 10.
I declare, under penalty of perjury, that the information in this report and attachments is true and complete to the best of my knowledge.
I authorize Treasury to discuss my return and attachments with my preparer.
Do not discuss my return with my preparer.
Authorized Signature
Signature of Preparer
Preparer FEIN
Printed Name
Date
Printed Name
Date
Title
Telephone Number
Address
Telephone Number
MAIL REPORT TO: Michigan Department of Treasury, P.O. Box 30474, Lansing, Michigan 48909-7974
www.michigan.gov/treasury
Questions ? - Please call (517) 636-4600
Michigan Department of Treasury
Reset Form
200-CCR
3715 (Rev. 09-12)
Carrier's Monthly Report: Pipeline, Barge, Marine Vessel
This form is issued under authority of P.A. 403 of 2000, as amended.
This report is due
2. Account Number (FEIN or TR)
2A. License Number
3. Report Period (MM/YYYY)
1. Company Name and Mailing Address
4. Contact Person Name
5. Telephone Number
6. Fax Number
7. E-mail Address
Net Gallons - Report Whole Gallons Only
This report must be filed by all carriers for
Column 6
Column 1
Column 2
Column 3
Column 4
Column 5
shipments into, out of and within the State of
Michigan.
Gasoline
Aviation
Other Products
Jet Fuel
Undyed
Dyed
Gasoline
See page 2 for instructions.
Diesel Fuel
Diesel Fuel
8. Total gallons of petroleum product
transported from Michigan to another state.
Enter total from attached Schedule(s) 14A.
9. Total gallons of petroleum product
transported from out-of-state terminals and
refineries into Michigan. Enter total from
attached Schedule(s) 14B.
10. Total gallons of petroleum product
transported from Michigan terminals and
refineries to locations elsewhere in
Michigan. Enter total from attached
Schedule(s) 14C.
11. Total gallons of petroleum product
transported. Add lines 8 through 10.
I declare, under penalty of perjury, that the information in this report and attachments is true and complete to the best of my knowledge.
I authorize Treasury to discuss my return and attachments with my preparer.
Do not discuss my return with my preparer.
Authorized Signature
Signature of Preparer
Preparer FEIN
Printed Name
Date
Printed Name
Date
Title
Telephone Number
Address
Telephone Number
MAIL REPORT TO: Michigan Department of Treasury, P.O. Box 30474, Lansing, Michigan 48909-7974
www.michigan.gov/treasury
Questions ? - Please call (517) 636-4600
Form 3715, Page 2
200-CCR
Instructions for Form 3715, Carrier's Monthly Report: Pipeline, Barge, Marine Vessel
This report must be filed by the 20th day of the month following the end of the report period by persons who transport product by pipeline, barge and/or
marine vessel. A "Carrier” is an operator of pipeline, barge and/or marine vessel engaged in the business of transporting motor fuel above the terminal
rack.
LINE INSTRUCTIONS.
(Lines not listed below are explained on the form.)
Line 1: Indicate changes to the company name and address by crossing out incorrect information and entering correct information.
Line 2A: Enter Taxpayer's 8-digit license number.
Line 3: Report Period. Enter the report period (example 06/2001 or June 2001).
Lines 4-7. Enter the name, phone number, fax number, and e-mail address of the individual who may be contacted for questions.
Lines 8-11: Complete lines 8-11 for each Fuel Type listed in Columns 1-5.
COLUMN 6, OTHER PRODUCTS.
When reporting "Other Product" not identified in Columns 1-5 on page 1, enter the combined total of all the schedules for "Other Products."
Product Codes (PC)
Enter the appropriate code on Schedule 14A, 14B and 14C. See attached list of product codes.
Form 3715, page 3
Michigan Fuel Product Codes
Gasoline
High Sulfur Kerosene - dye added ............ 074
Diesel Fuel #4 - dye added ........................ 153
Natural Gasoline ......................................... 061
High Sulfur Diesel - dye added ................. 226
Gasoline ....................................................... 065
Low Sulfur Diesel - dye added .................. 227
Gasoline MTBE ........................................... 071
Diesel Fuel - dye added .............................. 228
Transmix ...................................................... 100
No 1 Diesel - dye added ............................. 231
Blending Components ................................ 122
Dyed Biodiesel and Dyed Biodiesel Blends
Napthas ........................................................ 126
Product Codes for dyed biodiesel and dyed biodiesel
Toluene ........................................................ 199
blends will now be reported according to the blend
Raffinates ..................................................... 223
percentage. The prefix will be “D” plus the percent-
Liquid Natural Gas ...................................... 225
age. Example: A blend of 20% dyed biodiesel and
Ethanol and Ethanol Blends
80% dyed diesel will be reported as D20. Dyed
biodiesel (100% Bio) will be reported as D00.
Product Codes for Ethanol and Ethanol blends will
now be reported according to the blend percentage.
Aviation
The prefix will be “E” plus the percentage. Example:
Aviation Gas ................................................ 125
A blend of 10% Ethanol and 90% Gasoline will be
Jet Fuel ......................................................... 130
reported as E10. Ethanol (100%) will be reported as
Other
E00. All ethanol and ethanol blends will be taxed as
gasoline at the 19 cents tax rate.
Ethane .......................................................... 052
Undyed Diesel
Propane ........................................................ 054
Kerosene - undyed ...................................... 142
Butane .......................................................... 055
Low Sulfur Kerosene - undyed ................. 145
Isobutane ..................................................... 058
High Sulfur Kerosene - undyed ................. 147
Pentanes ....................................................... 059
No. 1 Fuel Oil - undyed ............................. 150
Propylene ..................................................... 075
Heating Oil .................................................. 152
Xylene .......................................................... 076
Diesel Fuel #4 - undyed ............................. 154
Excluded Liquid (Mineral Oil) ................... 077
Diesel Fuel - undyed ................................... 160
Additive Miscellaneous .............................. 090
Low Sulfur diesel # 1 - undyed ................. 161
Waste Oil ...................................................... 091
Low Sulfur diesel # 2 - undyed ................. 167
Undefined products .................................... 092
Mineral Oils ................................................. 281
MTBE ........................................................... 093
# 1 High Sulfur Diesel - undyed ................ 282
TAME ........................................................... 121
# 2 High Sulfur Diesel - undyed ................ 283
Residual Fuel Oil ......................................... 175
Undyed BioDiesel and BioDiesel Blends
Ethylene ....................................................... 196
Product Codes for biodiesel and biodiesel blends will
Butylene ....................................................... 198
now be reported according to the blend percentage.
CNG ............................................................. 224
The prefix will be “B” plus the percentage. Example:
Methanol ...................................................... 243
A blend of 20% biodiesel and 80% Diesel will be
Benzene ....................................................... 248
reported as B20. Biodiesel (B100) will be reported as
ETBE ............................................................ 249
B00. All undyed biodiesel and undyed biodiesel
blends will be taxed as diesel fuel at the 15 cents tax
Methane ....................................................... 265
rate.
Marine Diesel Oil ........................................ 279
Dyed Diesel
Soy Oil (unprocessed) ................................ 285
Kerosene - dye added ................................. 072
Organic Oils (food) ..................................... 960
Low Sulfur Kerosene - dye added ............. 073
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