Form RMFT-5-US-X Amended Return/Claim for Credit Underground Storage Tank Tax and Environmental Impact Fee - Illinois

Form RMFT-5-US-X is a Illinois Department of Revenue form also known as the "Amended Return/claim For Credit Underground Storage Tank Tax And Environmental Impact Fee". The latest edition of the form was released in December 1, 2017 and is available for digital filing.

Download an up-to-date Form RMFT-5-US-X in PDF-format down below or look it up on the Illinois Department of Revenue Forms website.

Step-by-step Form 5-US-X instructions can be downloaded by clicking this link.

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Illinois Department of Revenue
RMFT-5-US-X
Amended Return/Claim for Credit
REV 02
E S ___/___/___
Underground Storage Tank Tax and Environmental Impact Fee
NS DP CA
Do not write above this line.
Step 1: Identify yourself
Name
_______________________________________________
Original reporting period __________________/__ __ __ __
Month
Year
R
Address_______________________________________________
Receiver license number ____________________________
Number and street
______________________________________________________
Telephone no. (__ __ __) __ __ __ - __ __ __ __
City
State
ZIP
As originally reported
Corrected
Note: All calculations of tax are based on gallon measurements (i.e., a
liquid gallon, a gasoline gallon equivalent, or a diesel gallon equivalent).
or adjusted
amounts
For more information, see instructions for each column.
Column 1
Column 2
Column 1
Column 2
Gasoline and
Other fuels
Gasoline and
Other fuels
Step 2: Figure your total gallonage for the month
special fuel
special fuel
1
Enter your actual (stick) inventory at the beginning of the month. This
1
amount must agree with closing inventory of preceding month’s return.
2
Enter the number of invoiced gallons produced, acquired, received or
transported into Illinois during the month
a
Tax/fee-free invoiced gallons
2a
(Sch. A, SA, or DA, Column 1; Sch. LA, Column 2)
b
Tax/fee-paid invoiced gallons (Schedule E, SE, or LE (dyed
2b
diesel fuel), Column 1; other fuels, Sch. LE, Column 2)
3
Add Lines 1 through 2b and enter the result in Line 3. Remember
3
to do calculations within each column.
4
4
Enter your actual (stick) inventory at the end of the month.
5
5
Subtract Line 4 from Line 3 and enter the result on Line 5.
Step 3: Figure your nontaxable gallonage
6
Enter the number of gallons sold exempt in Illinois
a
6a
///////////////////
///////////////////
to railroads for direct rail operation (Schedule LB)
b
to qualified air carriers (Schedule LB, kerosene,
6b
Column 1; other fuels, Column 2)
c
6c
///////////////////
///////////////////
to qualified ships, barges, and vessels (Schedule LB)
7
Enter the number of gallons sold and delivered outside of Illinois
7
(Schedule C, SC, DC, Column 1; Schedule LC, Column 2)
8
Enter the number of gallons sold and distributed tax/fee-free to licensed
8
receivers (Schedule D, SD, or DD, Column 1; Schedule LD, Column 2)
9
Enter the number of gallons of your loss due to temperature variation
or evaporation or your gain due to temperature variation.
Complete Line 9a or 9b per column.
a
Loss. The amount of losses you claim are limited.
(
) (
)
(
) (
)
9a
See instructions.
or
b
9b
Gain.
10
Add Lines 6a through 9b and enter the result on Line 10.
10
This is your total nontaxable gallonage.
Step 4: Figure your gross non-aviation taxable gallonage
11
11
Subtract Line 10 from Line 5 and enter the result on Line 11.
12
Enter the number of gallons of aviation gas and jet fuel sold to
12
///////////////////
///////////////////
non-exempt air carriers from Schedule LB.
13
Enter the number of gallons of aviation gas and jet fuel sold for
13
///////////////////
///////////////////
purposes other than use in aircraft from Schedule LB.
14
Add Lines 12 and 13 and enter the result on Line 14.
14
///////////////////
///////////////////
This is your total non-exempt aviation fuel gallonage.
15
Subtract Line 14 from Line 11 and enter the result on Line 15.
15
This is your non-aviation gross taxable gallons.
This form is authorized as outlined by the Motor Fuel Tax Law. Disclosure of this
RMFT-5-US-X (R-12/17)
information is REQUIRED. Failure to provide information could result in a penalty.
Illinois Department of Revenue
RMFT-5-US-X
Amended Return/Claim for Credit
REV 02
E S ___/___/___
Underground Storage Tank Tax and Environmental Impact Fee
NS DP CA
Do not write above this line.
Step 1: Identify yourself
Name
_______________________________________________
Original reporting period __________________/__ __ __ __
Month
Year
R
Address_______________________________________________
Receiver license number ____________________________
Number and street
______________________________________________________
Telephone no. (__ __ __) __ __ __ - __ __ __ __
City
State
ZIP
As originally reported
Corrected
Note: All calculations of tax are based on gallon measurements (i.e., a
liquid gallon, a gasoline gallon equivalent, or a diesel gallon equivalent).
or adjusted
amounts
For more information, see instructions for each column.
Column 1
Column 2
Column 1
Column 2
Gasoline and
Other fuels
Gasoline and
Other fuels
Step 2: Figure your total gallonage for the month
special fuel
special fuel
1
Enter your actual (stick) inventory at the beginning of the month. This
1
amount must agree with closing inventory of preceding month’s return.
2
Enter the number of invoiced gallons produced, acquired, received or
transported into Illinois during the month
a
Tax/fee-free invoiced gallons
2a
(Sch. A, SA, or DA, Column 1; Sch. LA, Column 2)
b
Tax/fee-paid invoiced gallons (Schedule E, SE, or LE (dyed
2b
diesel fuel), Column 1; other fuels, Sch. LE, Column 2)
3
Add Lines 1 through 2b and enter the result in Line 3. Remember
3
to do calculations within each column.
4
4
Enter your actual (stick) inventory at the end of the month.
5
5
Subtract Line 4 from Line 3 and enter the result on Line 5.
Step 3: Figure your nontaxable gallonage
6
Enter the number of gallons sold exempt in Illinois
a
6a
///////////////////
///////////////////
to railroads for direct rail operation (Schedule LB)
b
to qualified air carriers (Schedule LB, kerosene,
6b
Column 1; other fuels, Column 2)
c
6c
///////////////////
///////////////////
to qualified ships, barges, and vessels (Schedule LB)
7
Enter the number of gallons sold and delivered outside of Illinois
7
(Schedule C, SC, DC, Column 1; Schedule LC, Column 2)
8
Enter the number of gallons sold and distributed tax/fee-free to licensed
8
receivers (Schedule D, SD, or DD, Column 1; Schedule LD, Column 2)
9
Enter the number of gallons of your loss due to temperature variation
or evaporation or your gain due to temperature variation.
Complete Line 9a or 9b per column.
a
Loss. The amount of losses you claim are limited.
(
) (
)
(
) (
)
9a
See instructions.
or
b
9b
Gain.
10
Add Lines 6a through 9b and enter the result on Line 10.
10
This is your total nontaxable gallonage.
Step 4: Figure your gross non-aviation taxable gallonage
11
11
Subtract Line 10 from Line 5 and enter the result on Line 11.
12
Enter the number of gallons of aviation gas and jet fuel sold to
12
///////////////////
///////////////////
non-exempt air carriers from Schedule LB.
13
Enter the number of gallons of aviation gas and jet fuel sold for
13
///////////////////
///////////////////
purposes other than use in aircraft from Schedule LB.
14
Add Lines 12 and 13 and enter the result on Line 14.
14
///////////////////
///////////////////
This is your total non-exempt aviation fuel gallonage.
15
Subtract Line 14 from Line 11 and enter the result on Line 15.
15
This is your non-aviation gross taxable gallons.
This form is authorized as outlined by the Motor Fuel Tax Law. Disclosure of this
RMFT-5-US-X (R-12/17)
information is REQUIRED. Failure to provide information could result in a penalty.
Form RMFT-5-US-X Page 2
As originally reported
Corrected
or adjusted
amounts
Column 1
Column 2
Column 1
Column 2
Gasoline and
Other fuels
Gasoline and
Other fuels
special fuel
special fuel
Step 5: Figure your non-aviation net taxable gallonage
16
Enter the number of non-aviation gallons on which the tax/fee was
16
paid at the time of purchase.
17
17
Subtract Line 16 from Line 15 and enter the result on Line 17.
18
Add Line 17, Column 1 and Line 17, Column 2.
18
This is your non-aviation net taxable gallonage.
Step 6: Figure your non-aviation tax and fee
19
Figure your gross non-aviation tax and fee due. Enter the amount from
Line 18 on the line provided below and multiply by the tax and fee rates
provided.
a
19a
For underground storage tank tax:
X 0.003.
$
$
Line 18, Col. 2
b
19b
For environmental impact fee:
X 0.008.
$
$
Line 18, Col. 2
c
19c
Add Lines 19a and 19b. This is your non-aviation gross tax and fee due.
$
$
20
If you originally filed and paid your tax and fee due on time, figure your
20
collection discount. See instructions.
$
$
21
Subtract Line 20 from Line 19c and enter the result on Line 21.
21
This is your non-aviation tax and fee due.
$
$
Step 7: Figure your aviation fuel tax and fee
22
22
Enter the total non-exempt aviation fuel gallonage from Line 14.
23
Enter the number of gallons of aviation fuel produced, acquired, or transported
23
into Illinois on which the tax/fee was paid at the time of purchase.
24
Subtract Line 23 from Line 22 and enter the result on Line 24.
24
This is your gross taxable gallons of aviation fuel.
25
Figure your gross tax and fee due. Enter the amount from Line 24 on the
line provided below and multiply by the tax and fee rates provided.
a
25a
For underground storage tank tax:
X 0.003.
$
$
Line 24, Col. 2
b
25b
For environmental impact fee:
X 0.008.
$
$
Line 24, Col. 2
c
25c
Add Lines 25a and 25b. This is your gross aviation fuel tax and fee due.
$
$
26
If you originally filed and paid your tax and fee due on time, figure your
26
collection discount. See instructions.
$
$
27
Subtract Line 26 from Line 25c and enter the result on Line 27.
27
This is your aviation fuel tax and fee due.
$
$
Step 8: Figure the amount you owe
28
Add Lines 21 and 27 and enter the result on Line 28.
28
This is your total tax and fee due.
$
$
29
29
Enter the amount of credit you wish to apply. (See instructions.)
$
$
30
Subtract Line 29 from Line 28 and enter the result on Line 30. This is
30
the tax/fee due.
$
$
31
31
Total amount paid to date for this reporting period.
$
32
If Corrected Amounts Column, Line 30 is greater than Line 31,
32
subtract Line 31 from Line 30. This is the amount you owe.
$
33
If Corrected Amounts Column, Line 30 is less than Line 31,
subtract Line 30 from Line 31. If you are claiming a credit, you must
33
complete Step 10.
$
RMFT-5-US-X (R-12/17)
Form RMFT-5-US-X Page 3
Step 9: Sign and date your amended return
Under penalties of perjury, I state that I have examined this return, and, to the best of my knowledge, it is true, correct, and complete.
Signature of person, other than taxpayer, who prepared this return
Date
Taxpayer’s name
Preparer’s phone number
Signature and title of taxpayer
Date
Step 10: Complete your claim for credit
Complete Lines 34 through 36 if you are claiming a credit.
34
Explain below why the amount for which you are filing this claim is alleged to be a mistake of fact or an error in law. Attach additional
sheets, if necessary.
35
Are you a party to any civil suits involving the above amounts?
yes
no
If “yes”, what is the name of the suit?
36
Sign below.
Signature of claimant
Title (State whether owner, partner, officer, or authorized agent)
Mail this return and payment to:
ILLINOIS DEPARTMENT OF REVENUE
PO BOX 19467
SPRINGFIELD IL 62794-9467
RMFT-5-US-X (R-12/17)
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