Form RMFT-119 Certificate of Exemption for Sale of Gasoline for the Use as Fuel in Aircraft - Illinois

Form RMFT-119 or the "Certificate Of Exemption For Sale Of Gasoline For The Use As Fuel In Aircraft" is a form issued by the Illinois Department of Revenue.

Download a PDF version of the Form RMFT-119 down below or find it on the Illinois Department of Revenue Forms website.

ADVERTISEMENT
Illinois Department of Revenue
RMFT-119
Certificate of Exemption for Sale of Gasoline for the
Use as Fuel in Aircraft
Scan and attach this certificate to your electronically filed Schedule B of Form RMFT-5, Motor Fuel Distributor/Supplier Tax Return.
Retain the original certificate in your records for inspection, if necessary. If you have any questions regarding this form or its filing,
contact us at 217 782-2291.
This is to certify that ___________________________________________ purchased _____________ gallons of gasoline
(name of purchaser)
from ___________________________________________________________________ on invoice number ____________________,
(name and address of motor fuel distributor)
dated ___ ___ / ___ ___ / ___ ___ ___ ___.
I further certify the entire amount of the purchase will be used as fuel in aircraft and is therefore exempt from Illinois motor fuel tax.
______________________________________
Name of purchaser
______________________________________
_____________________________________
Signature of authorized representative
Print name of authorized representative
______________________________________
___ ___ / ___ ___ / ___ ___ ___ ___
Title of authorized representative, if applicable
Date
Reset
Print
This form is authorized as outlined by the Motor Fuel Tax Law. Disclosure of this information is REQUIRED.
RMFT-119 (R-07/17)
Failure to provide information could result in a penalty.
Illinois Department of Revenue
RMFT-119
Certificate of Exemption for Sale of Gasoline for the
Use as Fuel in Aircraft
Scan and attach this certificate to your electronically filed Schedule B of Form RMFT-5, Motor Fuel Distributor/Supplier Tax Return.
Retain the original certificate in your records for inspection, if necessary. If you have any questions regarding this form or its filing,
contact us at 217 782-2291.
This is to certify that ___________________________________________ purchased _____________ gallons of gasoline
(name of purchaser)
from ___________________________________________________________________ on invoice number ____________________,
(name and address of motor fuel distributor)
dated ___ ___ / ___ ___ / ___ ___ ___ ___.
I further certify the entire amount of the purchase will be used as fuel in aircraft and is therefore exempt from Illinois motor fuel tax.
______________________________________
Name of purchaser
______________________________________
_____________________________________
Signature of authorized representative
Print name of authorized representative
______________________________________
___ ___ / ___ ___ / ___ ___ ___ ___
Title of authorized representative, if applicable
Date
Reset
Print
This form is authorized as outlined by the Motor Fuel Tax Law. Disclosure of this information is REQUIRED.
RMFT-119 (R-07/17)
Failure to provide information could result in a penalty.
ADVERTISEMENT