Form RMFT-6-SF Schedule Sa - Special Fuel (Excluding Dyed Diesel Fuel) Produced, Acquired, Received, or Transported Into Illinois - Illinois

Form RMFT-6-SF or the "Schedule Sa - Special Fuel (excluding Dyed Diesel Fuel) Produced, Acquired, Received, Or Transported Into Illinois" is a form issued by the Illinois Department of Revenue.

Download a PDF version of the Form RMFT-6-SF down below or find it on the Illinois Department of Revenue Forms website.

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Illinois Department of Revenue
MFT, UST, and EIF
Page ____ of ____
Schedule SA
Special Fuel (Excluding Dyed Diesel Fuel)
Produced, Acquired, Received, or Transported into Illinois
Attach to Form RMFT-5 or Form RMFT-5-US
Step 1: Complete the following information
______________________________________________
Check the tax/fee type you are listing on this page.
Check the receipt type that you are listing on this page.
Company name
MFT-free only
Received in Illinois
______________________________________________
UST-/EIF-free only
Imported into Illinois
Your license number
Reporting period __ __/__ __ __ __
Both MFT- and UST-/EIF-free
Produced in your Illinois refinery
Month
Year
Step 2: Report your tax- and fee-free purchases
1
2
3
4
5
6
7
8
9
Invoice date
Invoice
Name of
Bill of lading or
Origin
Destination
Seller’s
Invoiced
(month, day, year)
number
carrier
manifest number
Name of seller
(city and state)
(Illinois cities only)
license number
gallons
1
_ _/_ _/_ _ _ _ _________________________________ ___________________________________________________________________________________ _________________
2
_ _/_ _/_ _ _ _ ________________________________ ___________________________________________________________________________________ _________________
3
_ _/_ _/_ _ _ _ ________________________________ ___________________________________________________________________________________ _________________
4
_ _/_ _/_ _ _ _ ________________________________ ___________________________________________________________________________________ _________________
5
_ _/_ _/_ _ _ _ ________________________________ ___________________________________________________________________________________ _________________
6
_ _/_ _/_ _ _ _ ________________________________ ___________________________________________________________________________________ _________________
7
_ _/_ _/_ _ _ _ ________________________________ ___________________________________________________________________________________ _________________
8
_ _/_ _/_ _ _ _ ________________________________ ___________________________________________________________________________________ _________________
9
_ _/_ _/_ _ _ _ ________________________________ ___________________________________________________________________________________ _________________
10
_ _/_ _/_ _ _ _ ______________________________________________________________________________________________________________________________________
11 Add the invoiced gallons in Column 9, Lines 1 through 10, and write the total here.
11
________________
12 If you are filing only one Schedule SA, write the amount from Line 11 here.
12
________________
If you are reporting
• MFT-free gallons only, also write this amount on Form RMFT-5, Line 2a, Column 2.
• UST-/EIF-free gallons only, also write this amount on Form RMFT-5-US, Line 2a, Column 1.
• both MFT- and UST-/EIF-free gallons, also write this amount on Form RMFT-5, Line 2a, Column 2, and Form RMFT-5-US, Line 2a, Column 1.
If you are filing more than one Schedule SA, see instructions.
This form is authorized as outlined by the Motor Fuel Tax Law and the Environmental Impact Fee Law. Disclosure of this information is REQUIRED.
RMFT-6-SF front (R-12/99)
Failure to provide information could result in a penalty. This form has been approved by the Forms Management Center.
IL-492-1790
Illinois Department of Revenue
MFT, UST, and EIF
Page ____ of ____
Schedule SA
Special Fuel (Excluding Dyed Diesel Fuel)
Produced, Acquired, Received, or Transported into Illinois
Attach to Form RMFT-5 or Form RMFT-5-US
Step 1: Complete the following information
______________________________________________
Check the tax/fee type you are listing on this page.
Check the receipt type that you are listing on this page.
Company name
MFT-free only
Received in Illinois
______________________________________________
UST-/EIF-free only
Imported into Illinois
Your license number
Reporting period __ __/__ __ __ __
Both MFT- and UST-/EIF-free
Produced in your Illinois refinery
Month
Year
Step 2: Report your tax- and fee-free purchases
1
2
3
4
5
6
7
8
9
Invoice date
Invoice
Name of
Bill of lading or
Origin
Destination
Seller’s
Invoiced
(month, day, year)
number
carrier
manifest number
Name of seller
(city and state)
(Illinois cities only)
license number
gallons
1
_ _/_ _/_ _ _ _ _________________________________ ___________________________________________________________________________________ _________________
2
_ _/_ _/_ _ _ _ ________________________________ ___________________________________________________________________________________ _________________
3
_ _/_ _/_ _ _ _ ________________________________ ___________________________________________________________________________________ _________________
4
_ _/_ _/_ _ _ _ ________________________________ ___________________________________________________________________________________ _________________
5
_ _/_ _/_ _ _ _ ________________________________ ___________________________________________________________________________________ _________________
6
_ _/_ _/_ _ _ _ ________________________________ ___________________________________________________________________________________ _________________
7
_ _/_ _/_ _ _ _ ________________________________ ___________________________________________________________________________________ _________________
8
_ _/_ _/_ _ _ _ ________________________________ ___________________________________________________________________________________ _________________
9
_ _/_ _/_ _ _ _ ________________________________ ___________________________________________________________________________________ _________________
10
_ _/_ _/_ _ _ _ ______________________________________________________________________________________________________________________________________
11 Add the invoiced gallons in Column 9, Lines 1 through 10, and write the total here.
11
________________
12 If you are filing only one Schedule SA, write the amount from Line 11 here.
12
________________
If you are reporting
• MFT-free gallons only, also write this amount on Form RMFT-5, Line 2a, Column 2.
• UST-/EIF-free gallons only, also write this amount on Form RMFT-5-US, Line 2a, Column 1.
• both MFT- and UST-/EIF-free gallons, also write this amount on Form RMFT-5, Line 2a, Column 2, and Form RMFT-5-US, Line 2a, Column 1.
If you are filing more than one Schedule SA, see instructions.
This form is authorized as outlined by the Motor Fuel Tax Law and the Environmental Impact Fee Law. Disclosure of this information is REQUIRED.
RMFT-6-SF front (R-12/99)
Failure to provide information could result in a penalty. This form has been approved by the Forms Management Center.
IL-492-1790
General Instructions
What records must I keep?
Schedule SA is used for reporting the
Column 5 - Write the seller’s complete name.
following taxes:
You are required by law to keep books and
Column 6 - Write the city and the state (using the
• Motor Fuel Tax (MFT)
records showing all purchases, receipts, losses
two-character U.S. Post Office abbreviation) from
• Underground Storage Tank Tax (UST)
through any cause, sales, distributions, and use of
which the special fuel product originated.
• Environmental Impact Fee (EIF)
fuels.
Column 7 - Write the name of the Illinois city to
What if I need additional assistance?
Which special fuels must be reported
which the special fuel product was delivered.
on this schedule?
If you have questions about this schedule, write to us
Column 8 - Write the seller’s Illinois license number.
at Motor Fuel Tax, Illinois Department of Revenue,
The special fuels that must be reported on this
P .O. Box 19477, Springfield, Illinois 62794-9477, or
schedule include diesel and any other petroleum
Column 9 - Write the number of invoiced gallons.
call our Springfield office weekdays between 8 a.m.
products ( e.g., furnace oil, heating oil, range oil,
and 4:30 p.m. at 217 782-2291.
and kerosene) intended for use or offered for sale
Line 11 - Add the invoiced gallons reported in Col-
as a fuel for engines in which the fuel is injected
umn 9, Lines 1 through 10.
Step-by-Step Instructions
into the combustion chamber and ignited by
Line 12 - If you are filing more than one Schedule SA,
pressure without electric spark. This does not
include 1-K kerosene or dyed diesel fuel. Report
First, group together all Schedules SA that report
Step 1: Complete the following
dyed diesel fuel on Schedule DA, Form RMFT-6-DF.
• UST-/EIF-free only gallons. Add Lines 11 from
information
this group, and write the total on Line 12 of the
When do I file this schedule?
Write your company name, your license number,
last page.
and the period for which you are reporting. Check
You must file Schedule SA with Form RMFT-5,
• MFT-free only gallons. Add Lines 11 from this
the boxes next to the tax/fee type and the receipt
Motor Fuel Distributor/Supplier Tax Return, if you
group, and write the total on Line 12 of the last
type you are listing on this page. Report one tax/fee
are reporting MFT-free gallons only or both MFT-
page.
type and one receipt type only per page.
and UST-/EIF-free gallons.
• both MFT- and UST-/EIF-free gallons. Add
Lines 11 from this group, and write the total on
Step 2: Report your tax- and fee-free
You must file Schedule SA with Form RMFT-5-US,
Line 12 of the last page.
purchases
Underground Storage Tank Tax and Environmental
Then, add the totals from Lines 12 of the Sched-
Impact Fee Receiver Tax Return, if you are report-
Lines 1 through 10 —
ules SA that report
ing only UST-/EIF-free gallons.
• MFT-free only gallons and both MFT- and
Column 1 - Write the month, day, and year of the
UST-/EIF-free gallons and write this amount on
invoice.
What must I attach to this schedule?
Form RMFT-5, Line 2a, Column 2.
You must attach the credit invoices issued by the
Column 2 - Write the invoice number.
• UST-/EIF-free only gallons and both MFT- and
seller . We will return your credit invoices upon
UST-/EIF-free gallons and write this amount on
Column 3 - Write the carrier’s complete business
your request.
Form RMFT-5-US, Line 2a, Column 1.
name.
Column 4 - Write the bill of lading or manifest
number.
RMFT-6-SF back (R-12/99)
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