Form B&L: MFT-PRDFG "Licensed Distributor Petition for Refund" - Alabama

What Is Form B&L: MFT-PRDFG?

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 July 1, 2015;
  • 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-PRDFG 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-PRDFG "Licensed Distributor Petition for Refund" - Alabama

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B&L: MFT-PRDFG
lAbAmA
epArtment of
evenue
7/15
b
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usiness
icense
Ax
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p.o. box 327540 • montgomery, Al 36132-7540 • (334) 242-9608 • fax (334) 242-1199
www.revenue.alabama.gov
licensed Distributor petition for refund
FEDERAL GOVERNMENT ONLY
For Motor Fuel Sales to Exempt Entities Licensed in Accordance with Section 40-17-332(j)
NAME
MONTH ENDING
ADDRESS
LICENSE NUMBER
CITY
STATE
ZIP
FEIN
CONTACT PERSON
TELEPHONE NUMBER
(            )
E-MAIL ADDRESS
Check here if new address
1. Total gallons sold to licensed
TAX REFUND CALCULATION:
Gasoline
Undyed Diesel
Aviation Gas
Jet Fuel
federal government exempt
entities (round to whole gallons) . . . .
0
0
0
2. Excise tax rate . . . . . . . . . . . . . . . . . .
X                      $0.18
X                      $0.19
X                    $0.095
X                    $0.035
3. Refund total
(line 1 multiplied by line 2) . . . . . . . . . $
$
$
$
0.00
0.00
0.00
0.00
4. Total gallons sold to licensed federal
REFUND ALLOWANCE CALCULATION:
government exempt entities (round
to whole gallons) . . . . . . . . . . . . . . . .
5. Refund allowance rate . . . . . . . . . . . .
X                      $0.02
X                      $0.02
6. Allowance total
(line 4 multiplied by line 5) . . . . . . . . . $
$
Due (line 3 plus line 6) . . . . . . . . . . $
$
7. Total Refund and Allowance
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 sold to the licensed federal government exempt entities without the state excise tax, and that said
petitioner is entitled to such refund under the provisions of Section 40-17-329(b).
Signature: _________________________________________________________________ Date: ___________________________________
Title or Position: _____________________________________________________________________________________________________
Records to clearly substantiate the above petition must be maintained by the licensed distributor 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 of
sale of the fuel to the licensed federal government exempt entity. The petition must be filed on a monthly basis with a separate petition for each
month and cannot include any sales for any other period. A summary listing of sales must be attached stating the licensed federal government
exempt entity name, license number, and number of motor fuel gallons. Please see instructions for further details.
RESET
A
D
r
B&L: MFT-PRDFG
lAbAmA
epArtment of
evenue
7/15
b
& l
t
D
usiness
icense
Ax
ivision
m
f
s
otor
uels
ection
p.o. box 327540 • montgomery, Al 36132-7540 • (334) 242-9608 • fax (334) 242-1199
www.revenue.alabama.gov
licensed Distributor petition for refund
FEDERAL GOVERNMENT ONLY
For Motor Fuel Sales to Exempt Entities Licensed in Accordance with Section 40-17-332(j)
NAME
MONTH ENDING
ADDRESS
LICENSE NUMBER
CITY
STATE
ZIP
FEIN
CONTACT PERSON
TELEPHONE NUMBER
(            )
E-MAIL ADDRESS
Check here if new address
1. Total gallons sold to licensed
TAX REFUND CALCULATION:
Gasoline
Undyed Diesel
Aviation Gas
Jet Fuel
federal government exempt
entities (round to whole gallons) . . . .
0
0
0
2. Excise tax rate . . . . . . . . . . . . . . . . . .
X                      $0.18
X                      $0.19
X                    $0.095
X                    $0.035
3. Refund total
(line 1 multiplied by line 2) . . . . . . . . . $
$
$
$
0.00
0.00
0.00
0.00
4. Total gallons sold to licensed federal
REFUND ALLOWANCE CALCULATION:
government exempt entities (round
to whole gallons) . . . . . . . . . . . . . . . .
5. Refund allowance rate . . . . . . . . . . . .
X                      $0.02
X                      $0.02
6. Allowance total
(line 4 multiplied by line 5) . . . . . . . . . $
$
Due (line 3 plus line 6) . . . . . . . . . . $
$
7. Total Refund and Allowance
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 sold to the licensed federal government exempt entities without the state excise tax, and that said
petitioner is entitled to such refund under the provisions of Section 40-17-329(b).
Signature: _________________________________________________________________ Date: ___________________________________
Title or Position: _____________________________________________________________________________________________________
Records to clearly substantiate the above petition must be maintained by the licensed distributor 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 of
sale of the fuel to the licensed federal government exempt entity. The petition must be filed on a monthly basis with a separate petition for each
month and cannot include any sales for any other period. A summary listing of sales must be attached stating the licensed federal government
exempt entity name, license number, and number of motor fuel gallons. Please see instructions for further details.
Summary Listing of Sales to Licensed Federal Government Exempt Entities
LICENSED EXEMPT ENTITY NAME
EXEMPT NO.
GASOLINE GALLONS
UNDYED DIESEL GALLONS
AVIATION GAS
JET FUEL
B&L: MFT-PRDFG-INS
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LABAMA
EPARTMENT OF
EVENUE
Instructions For Form B&L: MFT-PRDFG
Claim for Licensed Distributor Petition for Refund
FEDERAL GOVERNMENT ONLY
WHO MAY FILE. A licensed distributor who has sold
5. The refund allowance rate is $0.02 per gallon.
motor fuel without the state excise tax to a licensed
6. Multiply the total number of gallons by the refund
federal government exempt entity as listed in
allowance rate to compute the allowance(s) due.
accordance with Section 40-17-332(j).
7. Add the refund total(s) and the refund allowance
total(s) to find the total amount to be refunded.
WHEN TO FILE. The petition must be filed on a
DOCUMENTATION REQUIRED. A summary listing of
monthly basis with a separate petition for each month
and cannot include any sales for any other period. The
sales to licensed federal government exempt entities
statute of limitations for filing a refund is within two (2)
must be attached to the petition for refund. The listing
years from the date that the fuel was sold to the
must include the licensed federal government exempt
licensed exempt entity.
entity name, exempt license number, and the number
of gasoline and/or undyed diesel fuel gallons sold.
WHERE TO FILE. The claim must be filed with the
APPEAL PROCEDURES. According to Section 40-
Alabama Department of Revenue, Business & License
Tax Division, Motor Fuels Section, P.O. Box 327540,
2A-7, Code of Alabama 1975, you may appeal a denial
Montgomery, AL 36132-7540.
of this claim within two years of written notice of denial
by filing a notice of appeal with the Alabama Tax
TAX REFUND CALCULATION.
Tribunal, 2 North Jackson Street, Suite 301,
1. Enter the total number of gasoline, undyed diesel
Montgomery, AL 36104. You have the option of
fuel, aviation gas, or jet fuel gallons sold to a
appealing to the Circuit Court in Montgomery County,
licensed federal government exempt entity. (Round
Alabama, or to the Alabama Circuit Court of the county
to Whole Gallons)
in which you reside or have a principal place of
2. The state excise tax rate on gasoline is $0.18,
business. Please provide a copy of the appeal to this
undyed diesel fuel is $0.19, aviation gas is $0.095,
office.
and jet fuel is $0.035.
PENALTIES. Any applicant who willfully files an
3. Multiply the total number of gallons by the excise
tax rate(s) to compute the refund total(s).
inaccurate petition or false claim for a refund shall be
subject to a penalty of 100 percent (100%) of the
REFUND ALLOWANCE CALCULATION.
refund claimed, plus interest.
4. Enter the total number of gasoline and/or undyed
TAXPAYER ASSISTANCE. If you need further
diesel fuel gallons sold to a licensed federal
government exempt entity. (Round to Whole
information or have any questions, please contact the
Gallons)
Motor Fuels Section at (334) 242-9608.
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