Form B&L: MFT-PRC "Credit Card Issuer Petition for Refund" - Alabama

What Is Form B&L: MFT-PRC?

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

Form Details:

  • Released on February 1, 2016;
  • The latest edition provided by the Alabama Department of Revenue;
  • 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 B&L: MFT-PRC by clicking the link below or browse more documents and templates provided by the Alabama Department of Revenue.

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Download Form B&L: MFT-PRC "Credit Card Issuer Petition for Refund" - Alabama

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p.o. box 327540 • montgomery, Al 36132-7540 • (334) 242-9608 • fax (334) 242-1199
www.revenue.alabama.gov
credit card issuer petition for refund
For Gasoline and Diesel Fuel Purchases by Licensed Exempt Entities
NAME
QUARTER ENDING
ADDRESS
FEIN
CITY
STATE
ZIP
CONTACT PERSON
TELEPHONE NUMBER
(        )
E-MAIL ADDRESS
Check here if new address
1. Total gallons billed to licensed exempt entities
TAX REFUND CALCULATION:
Gasoline
Undyed Diesel
without the excise tax (round to whole gallons) . . . . . . . . . . . . .
$0.16
$0.19
2. Excise tax rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
X 
X 
3. Refund total (line 1 multiplied by line 2) . . . . . . . . . . . . . . . . . . .
I declare under the penalties of perjury that this claim has been examined by me and to the best of my knowledge and belief is true and
correct, and that the number of gallons claimed were billed to the licensed exempt entities without the state excise tax, and that said
petitioner is entitled to such refund under the provisions of Section 40-17 -329(f).
Signature: _________________________________________________________________ Date: ____________________________
Title or Position: ______________________________________________________________________________________________
Records to clearly substantiate the above petition must be maintained by the credit card issuer for a period of six years and must be
made available to the Alabama Department of Revenue or its authorized agents upon request. The statute of limitations is two years
from the date the credit card purchase was made by the licensed exempt entity. The petition must be filed on a quarterly basis with a
separate petition for each quarter and cannot include any purchases for any other period. A listing of purchases must be attached
stating the date of the credit card purchase made by the licensed exempt entity, the licensed exempt entity name, exempt license
number, vendor name and location, invoice number, product type, and number of gasoline and/or undyed diesel fuel gallons. Please
see instructions for further details.
RESET
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B&L: MFT-PRC
lAbAmA
epArtment of
evenue
2/16
b
& l
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usiness
icense
Ax
ivision
m
f
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otor
uels
ection
p.o. box 327540 • montgomery, Al 36132-7540 • (334) 242-9608 • fax (334) 242-1199
www.revenue.alabama.gov
credit card issuer petition for refund
For Gasoline and Diesel Fuel Purchases by Licensed Exempt Entities
NAME
QUARTER ENDING
ADDRESS
FEIN
CITY
STATE
ZIP
CONTACT PERSON
TELEPHONE NUMBER
(        )
E-MAIL ADDRESS
Check here if new address
1. Total gallons billed to licensed exempt entities
TAX REFUND CALCULATION:
Gasoline
Undyed Diesel
without the excise tax (round to whole gallons) . . . . . . . . . . . . .
$0.16
$0.19
2. Excise tax rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
X 
X 
3. Refund total (line 1 multiplied by line 2) . . . . . . . . . . . . . . . . . . .
I declare under the penalties of perjury that this claim has been examined by me and to the best of my knowledge and belief is true and
correct, and that the number of gallons claimed were billed to the licensed exempt entities without the state excise tax, and that said
petitioner is entitled to such refund under the provisions of Section 40-17 -329(f).
Signature: _________________________________________________________________ Date: ____________________________
Title or Position: ______________________________________________________________________________________________
Records to clearly substantiate the above petition must be maintained by the credit card issuer for a period of six years and must be
made available to the Alabama Department of Revenue or its authorized agents upon request. The statute of limitations is two years
from the date the credit card purchase was made by the licensed exempt entity. The petition must be filed on a quarterly basis with a
separate petition for each quarter and cannot include any purchases for any other period. A listing of purchases must be attached
stating the date of the credit card purchase made by the licensed exempt entity, the licensed exempt entity name, exempt license
number, vendor name and location, invoice number, product type, and number of gasoline and/or undyed diesel fuel gallons. Please
see instructions for further details.
Instructions for Preparing
Credit Card Issuer Petition for Refund
(Form B&L: MFT-PRC)
DOCUMENTATION REQUIRED. A listing/report of
WHO MAY FILE. A credit card issuer who bills a
purchases by licensed exempt entities must be
licensed exempt entity as listed in Section 40-17-
attached to the petition for refund. The listing/report
329(e) without the state excise tax for gasoline and/or
must include the date of credit card purchases made
undyed diesel fuel purchased by a licensed exempt
by the licensed exempt entity, licensed exempt entity
entity at a fixed retail pump available to the public with
the issuer's credit card.
name, exempt license number, name of vendor and
location, invoice number, product type, and the number
WHEN TO FILE. The petition must be filed on a
of gasoline and/or undyed diesel fuel gallons billed by
quarterly basis with a separate petition for each quarter
the credit card issuer without the tax.
and cannot include any purchases for any other period.
APPEAL PROCEDURES. According to Section 40-
The statute of limitations for filing a refund is within two
(2) years from the date that the fuel was purchased by
2A-7, Code of Alabama 1975, you may appeal a denial
the exempt entity using the issuer's credit card.
of this claim within two years of written notice of denial
by filing a notice of appeal with the Alabama Tax
WHERE TO FILE. The claim must be filed with the
Tribunal, 2 North Jackson Street, Suite 301,
Alabama Department of Revenue, Business & License
Montgomery, AL 36104. You have the option of
appealing to the Circuit Court in Montgomery County,
Tax Division, Motor Fuels Section, P.O. Box 327540,
Montgomery, AL 36132-7540.
Alabama, or to the Alabama Circuit Court of the county
in which you reside or have a principal place of
TAX REFUND CALCULATION.
business. Please provide a copy of the appeal to this
1. Enter the total number of gasoline and/or undyed
office.
diesel fuel gallons billed to the licensed exempt
PENALTIES. Any applicant who willfully files an
entity without the excise tax.
2. The state excise tax rate on gasoline is $.16 and on
inaccurate petition or false claim for a refund shall be
diesel fuel is $.19.
subject to a penalty of 100 percent (100%) of the
3. Multiply the total number of gallons by the excise
refund claimed, plus interest.
tax rate to compute the refund total.
TAXPAYER ASSISTANCE. If you need further
information or have any questions, please contact the
Motor Fuels Section at (334) 242-9608.
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