Form 3716 (100-TOR) "Terminal Operator Monthly Report" - Michigan

What Is Form 3716 (100-TOR)?

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;

Download a fillable version of Form 3716 (100-TOR) by clicking the link below or browse more documents and templates provided by the Michigan Department of Treasury.

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Download Form 3716 (100-TOR) "Terminal Operator Monthly Report" - Michigan

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Michigan Department of Treasury
100-TOR
3716 (Rev. 09-12)
This form is issued under authority of P.A. 403 of 2000, as amended. Filing is mandatory.
Terminal Operator Monthly Report
This report is due
3. Report Period (MM/YYYY)
2. Account Number (FEIN or TR)
2A. License Number
1. Company Name and Mailing Address
4. Contact Person Name
5. Telephone Number
6. Fax Number
7. E-mail Address
    
8. Terminal Control Number (TCN)
9. Location of Terminal (City and State)
This report must be filed by all terminal
operators. A separate report and
Net Gallons - Report Whole Gallons Only
schedules must be filed for each IRS-
Gasoline
Ethanol
Aviation
Undyed
Undyed
Dyed
Other
approved terminal.
Blends
Gasoline
Jet Fuel
Petroleum
Biodiesel
Diesel Fuel
Products
See page 2 for instructions.
E70 - E99
B05 or higher
Diesel
10. Beginning Inventory (Michigan terminals only).
    
11. Total Receipts (Schedule 15A)
    
(Michigan terminals only).
12. Total Gallons Available. (Michigan terminals
    
only) Add lines 10 and 11.
13. Total Disbursements (Schedule 15B).
    
14. Computed Ending Inventory (Michigan terminals
    
only). Subtract line 13 from line 12.
15. Actual Physical Ending Inventory
    
(Michigan terminals only).
16. Gains & Losses. (Losses need to be reported
    
with parenthesis around the loss) (Michigan
terminals only) Subtract line 14 from line 15.
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.
Questions ? - Please call (517) 636-4600
www.michigan.gov/treasury
Reset Form
Michigan Department of Treasury
100-TOR
3716 (Rev. 09-12)
This form is issued under authority of P.A. 403 of 2000, as amended. Filing is mandatory.
Terminal Operator Monthly Report
This report is due
3. Report Period (MM/YYYY)
2. Account Number (FEIN or TR)
2A. License Number
1. Company Name and Mailing Address
4. Contact Person Name
5. Telephone Number
6. Fax Number
7. E-mail Address
    
8. Terminal Control Number (TCN)
9. Location of Terminal (City and State)
This report must be filed by all terminal
operators. A separate report and
Net Gallons - Report Whole Gallons Only
schedules must be filed for each IRS-
Gasoline
Ethanol
Aviation
Undyed
Undyed
Dyed
Other
approved terminal.
Blends
Gasoline
Jet Fuel
Petroleum
Biodiesel
Diesel Fuel
Products
See page 2 for instructions.
E70 - E99
B05 or higher
Diesel
10. Beginning Inventory (Michigan terminals only).
    
11. Total Receipts (Schedule 15A)
    
(Michigan terminals only).
12. Total Gallons Available. (Michigan terminals
    
only) Add lines 10 and 11.
13. Total Disbursements (Schedule 15B).
    
14. Computed Ending Inventory (Michigan terminals
    
only). Subtract line 13 from line 12.
15. Actual Physical Ending Inventory
    
(Michigan terminals only).
16. Gains & Losses. (Losses need to be reported
    
with parenthesis around the loss) (Michigan
terminals only) Subtract line 14 from line 15.
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.
Questions ? - Please call (517) 636-4600
www.michigan.gov/treasury
100-TOR
Form 3716, Page 2
Instructions for Form 3716, Terminal Operator Monthly Report
This report must be filed by the 20th day of the month following the end of the report period by all terminals in Michigan and out-of-state terminals who disburse fuel with a Michigan
desination. A separate report must be filed for each terminal.
LINE INSTRUCTIONS (Lines not listed below are explained on the form.)
For terminals located outside of Michigan, enter only disbursements made with a Michigan destination (Line 13).
Line 1. Indicate changes to the company name and address by crossing out incorrect information and entering correct information.
Line 2. Enter taxpayer Federal Identification Number (FEIN or TR).
Line 2A. Enter taxpayer's 8-digit license number.
Line 3. 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.
Line 8. Enter the Terminal Control Number (TCN). A separate report and schedules must be completed for each terminal.
Line 9. Enter the city and state of the physical location of the terminal.
Lines 10-16. Enter the inventory amounts for each column in NET GALLONS.
Products not identified in Columns 1 through 7 must be reported in Column 8, Other Products.
Line 10: Beginning Inventory. Enter the Actual Physical Ending Inventory from line 15 of the previous month’s report.
Line 11: Total Receipts. Enter the total from all schedules 15A by Product Type.
Line 13: Total Disbursements. Enter the total from all schedules 15B by Product Type.
Line 15: Actual Physical Ending Inventory (Michigan Terminals Only). Enter the physical inventory taken at the terminal at the end of the reporting period.
Column 8, Other Products
When reporting "Other Products" not identified in Columns 1-7 on Page 1, enter the combined total of all schedules for "Other Products".
Product Codes
Enter the appropriate code on Schedules 15A and 15B. See attached list of product codes.
Form 3716, Page 3
Michigan Fuel Product Codes
Gasoline
Dyed Biodiesel and Dyed Biodiesel Blends
Natural Gasoline ......................................... 061
Product Codes for dyed biodiesel and dyed
Gasoline ....................................................... 065
biodiesel blends will now be reported according to the
Gasoline MTBE ........................................... 071
blend percentage. The prefix will be “D” plus the per-
Transmix ...................................................... 100
centage. Example: A blend of 20% dyed biodiesel and
Blending Components ................................ 122
80% dyed diesel will be reported as D20. Dyed
Napthas ........................................................ 126
biodiesel (100% Bio) will be reported as D00.
Toluene ........................................................ 199
Raffinates ..................................................... 223
Aviation
Liquid Natural Gas ...................................... 225
Aviation Gas ................................................ 125
Ethanol and Ethanol Blends
Jet Fuel ......................................................... 130
Product Codes for Ethanol and Ethanol blends will
Other
now be reported according to the blend percentage. The
Ethane .......................................................... 052
Propane ........................................................ 054
prefix will be “E” plus the percentage. Example: A blend
Butane .......................................................... 055
of 10% Ethanol and 90% Gasoline will be reported as
Isobutane ..................................................... 058
E10. Ethanol (100%) will be reported as E00. All
Pentanes ....................................................... 059
ethanol and ethanol blends will be taxed as gasoline at the
Propylene ..................................................... 075
19 cents tax rate.
Xylene .......................................................... 076
Undyed Diesel
Excluded Liquid (Mineral Oil) ................... 077
Kerosene - undyed ...................................... 142
Additive Miscellaneous .............................. 090
Low Sulfur Kerosene - undyed ................. 145
Waste Oil ...................................................... 091
High Sulfur Kerosene - undyed ................. 147
Undefined products .................................... 092
No. 1 Fuel Oil - undyed ............................. 150
MTBE ........................................................... 093
Heating Oil .................................................. 152
TAME ........................................................... 121
Diesel Fuel #4 - undyed ............................. 154
Residual Fuel Oil ......................................... 175
Diesel Fuel - undyed ................................... 160
Ethylene ....................................................... 196
Low Sulfur diesel # 1 - undyed ................. 161
Butylene ....................................................... 198
Low Sulfur diesel # 2 - undyed ................. 167
CNG ............................................................. 224
Mineral Oils ................................................. 281
Methanol ...................................................... 243
# 1 High Sulfur Diesel - undyed ................ 282
Benzene ....................................................... 248
# 2 High Sulfur Diesel - undyed ................ 283
ETBE ............................................................ 249
Methane ....................................................... 265
Undyed BioDiesel and BioDiesel Blends
Marine Diesel Oil ........................................ 279
Product Codes for biodiesel and biodiesel blends
Soy Oil (unprocessed) ................................ 285
will now be reported according to the blend percentage.
Organic Oils (food) ..................................... 960
The prefix will be “B” plus the percentage. Example: A
blend of 20% biodiesel and 80% Diesel will be reported
as B20. Biodiesel (B100) will be reported as B00. All
undyed biodiesel and undyed biodiesel blends will be
taxed as diesel fuel at the 15 cents tax rate.
Dyed Diesel
Kerosene - dye added ................................. 072
Low Sulfur Kerosene - dye added ............. 073
High Sulfur Kerosene - dye added ............ 074
Diesel Fuel #4 - dye added ........................ 153
High Sulfur Diesel - dye added ................. 226
Low Sulfur Diesel - dye added .................. 227
Diesel Fuel - dye added .............................. 228
No 1 Diesel - dye added ............................. 231
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