Form MC367 "Biodiesel Producer / User Application" - Nevada

What Is Form MC367?

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

Form Details:

  • Released on July 1, 2008;
  • The latest edition provided by the Nevada Department of Motor Vehicles;
  • 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 MC367 by clicking the link below or browse more documents and templates provided by the Nevada Department of Motor Vehicles.

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Download Form MC367 "Biodiesel Producer / User Application" - Nevada

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MOTOR CARRIER DIVISION
555 WRIGHT WAY
CARSON CITY, NV 89711-0600
(775) 684-4711 fax (775) 684-4619
www.dmvnv.com
For Office Use Only
Date Received
Date Approved
Date Issued
Initials
Account Number
BIODIESEL PRODUCER / USER APPLICATION
Indicate the type of fuel:
Biodiesel Producer/User
Vegetable Oil Refiner/User
Used Fryer Oil Refiner/User
Motor Oil User
Syntroleum User
Other ___________________
1.
Applicant's Name:_______________________________________________________________________________
2.
Location Address:________________________________________________________________________________
(Street Address)
__________________________________________________________________________________________________
(City, State, Zip)
3.
Mailing
Address:______________________________________________________________________________
(Street Address)
__________________________________________________________________________________________________
(City, State, Zip)
__________________________________________________________________________________________________
(Telephone Number, Fax Number, Email Address)
4.
List the company names and addresses you anticipate purchasing used oil products from: _____________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
5.
Enter estimated number of gallons produced per month
Enter fuel type
6.
List any bulk storage facilities where fuel will be stored:___________________________________________________
(Location, Tank Capacity)
7.
Person responsible for filing monthly tax reports:
__________________________________________________________________________________________________
(Name, Telephone Number, Email Address)
The undersigned hereby swears or affirms, under penalties of perjury, that this application has been examined and is true,
correct and complete.
___________________________________________
_________________________________________
Applicant Signature
Date
___________________________________________
Print or Type Applicant Name
By cooperative agreement, the State of Nevada, Department of Motor Vehicles, Motor Carrier Division exchanges fuel tax information with other collecting agencies.
MC367 (7/2008)
MOTOR CARRIER DIVISION
555 WRIGHT WAY
CARSON CITY, NV 89711-0600
(775) 684-4711 fax (775) 684-4619
www.dmvnv.com
For Office Use Only
Date Received
Date Approved
Date Issued
Initials
Account Number
BIODIESEL PRODUCER / USER APPLICATION
Indicate the type of fuel:
Biodiesel Producer/User
Vegetable Oil Refiner/User
Used Fryer Oil Refiner/User
Motor Oil User
Syntroleum User
Other ___________________
1.
Applicant's Name:_______________________________________________________________________________
2.
Location Address:________________________________________________________________________________
(Street Address)
__________________________________________________________________________________________________
(City, State, Zip)
3.
Mailing
Address:______________________________________________________________________________
(Street Address)
__________________________________________________________________________________________________
(City, State, Zip)
__________________________________________________________________________________________________
(Telephone Number, Fax Number, Email Address)
4.
List the company names and addresses you anticipate purchasing used oil products from: _____________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
5.
Enter estimated number of gallons produced per month
Enter fuel type
6.
List any bulk storage facilities where fuel will be stored:___________________________________________________
(Location, Tank Capacity)
7.
Person responsible for filing monthly tax reports:
__________________________________________________________________________________________________
(Name, Telephone Number, Email Address)
The undersigned hereby swears or affirms, under penalties of perjury, that this application has been examined and is true,
correct and complete.
___________________________________________
_________________________________________
Applicant Signature
Date
___________________________________________
Print or Type Applicant Name
By cooperative agreement, the State of Nevada, Department of Motor Vehicles, Motor Carrier Division exchanges fuel tax information with other collecting agencies.
MC367 (7/2008)
MOTOR CARRIER DIVISION
555 WRIGHT WAY
CARSON CITY, NV 89711-0600
(775) 684-4711
FAX (775) 684-4619
www.dmvnv.com
Biodiesel Producer / User Application Information and Instructions
This Application must be typewritten or printed in ink, in its entirety, and be accepted
and approved by the Nevada Department of Motor Vehicles. A Biodiesel Producer /
User License must be received prior to adapting product received for use in a motor
vehicle. It is understood this application is completed to allow an individual to self-
report the acquisition and use of all alternative fuels used to propel a motor vehicle.
Please mail this original application, with the appropriate attachments to the address
shown above.
Monthly Reporting:
All biodiesel produced and used in Nevada must be tracked and reported to the
Department on a monthly basis. The documentation for the monthly report must fall
within the period beginning and ending dates indicated on the report.
Verification and Audit:
The records required to substantiate the monthly reporting must be retained and available
for at least 4 years for verification and audit purposes. The required records to be
provided for an audit include: original oil receipts, fuel production logs, bulk tank fuel
logs, and equipment lists.
MC367i (07/2008)
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