Form 4429 "Retail Marine Diesel Dealer Schedule of Disbursement" - Michigan

What Is Form 4429?

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, 2008;
  • 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 4429 by clicking the link below or browse more documents and templates provided by the Michigan Department of Treasury.

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Download Form 4429 "Retail Marine Diesel Dealer Schedule of Disbursement" - Michigan

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Michigan Department of Treasury
4429 (Rev. 9-08)
Retail Marine Diesel Dealer Schedule of Disbursement
Product Code (see instructions on Page 2)
This form is issued under authority of P.A. 403 of 2000, as amended. Filing is mandatory.
Company Name
Account Number (FEIN or TR)
License Number
Report Period (MM/CCYY)
Schedule Types: Check the appropriate box. See page 2 for schedule descriptions. Do not combine schedule types or product codes.
6F
9
8
Report Whole Gallons Only
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
Gallons
Point of
Sold to Purchaser
Date
Document
Carrier Name
Carrier FEIN
Mode
Shipped
Number
N/A
Origin
Destination
Name
FEIN
N/A
Gross
TOTAL
www.michigan.gov/treasury
Reset Form
Michigan Department of Treasury
4429 (Rev. 9-08)
Retail Marine Diesel Dealer Schedule of Disbursement
Product Code (see instructions on Page 2)
This form is issued under authority of P.A. 403 of 2000, as amended. Filing is mandatory.
Company Name
Account Number (FEIN or TR)
License Number
Report Period (MM/CCYY)
Schedule Types: Check the appropriate box. See page 2 for schedule descriptions. Do not combine schedule types or product codes.
6F
9
8
Report Whole Gallons Only
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
Gallons
Point of
Sold to Purchaser
Date
Document
Carrier Name
Carrier FEIN
Mode
Shipped
Number
N/A
Origin
Destination
Name
FEIN
N/A
Gross
TOTAL
www.michigan.gov/treasury
Form 4429, Page 2
Instructions for Form 4429, Retail Marine Diesel Dealer Schedule of Disbursements
General Instructions
Schedule Types - Check the appropriate box on page 1. Complete a separate schedule for each schedule type and product code.
6F
Gallons of dyed diesel/dyed biodiesel fuel sold or removed for tax-exempt purposes.
8
Gallons sold tax-free to U.S. government located in Michigan.
9
Gallons sold tax-free to state and /or local government in Michigan, including public schools. Undyed diesel, undyed biodiesel, and dyed biodiesel only.
Product Codes - Enter the appropriate code on page 1. See the Retail Marine Diesel Dealer Return Instructions or Treasury's Web site for a list of
product codes.
Column Instructions
Column (1) & (2):
Carrier - Enter the name and Federal Employer ID Number (FEIN) of the company that transports the product.
Column (3):
Mode of Transport - Enter the mode of transport. Use one of the following:
J = Truck
R = Rail
B = Barge
PL = Pipeline
S = Ship (Great Lakes or ocean marine vessel)
Column (4):
Point of Origin/Destination - Enter the location the product was transported from/to. When received into or from a terminal, the Terminal
Control Number (TCN) must be used.
Column (5) & (6):
Sold To - Enter name of purchaser and FEIN.
Column (7):
Date Shipped - Enter the date the product was shipped.
Column (8):
Document Number - Enter the bill of lading number from the manifest issued at the terminal when product is removed over the rack. In the
case of bulk plant removals, use the withdrawal bill of ladding number or invoice number.
Column (9):
Not Applicable (N/A)
Column (10):
Gross Gallons - Enter the gross amount of gallons disbursed.
Column (11):
Not Applicable (N/A)
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