Form 1784 "Summary for Amending Motor Fuel Tax Returns" - South Dakota

What Is Form 1784?

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

Form Details:

  • Released on November 1, 2017;
  • The latest edition provided by the South Dakota 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 1784 by clicking the link below or browse more documents and templates provided by the South Dakota Department of Revenue.

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Download Form 1784 "Summary for Amending Motor Fuel Tax Returns" - South Dakota

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SD EForm - 1784
V2
Complete and use the button at the end to print for mailing.
HELP
SUMMARY FOR AMENDING
Department of Revenue
MOTOR FUEL TAX RETURNS
Motor Fuel Tax
445 East Capitol Avenue
Pierre, SD 57501-3100
Please Type or Print:
1. License Number:_____________________________________________________________
2. Federal ID or Social Security Number:____________________________________________
3. Business Name:_____________________________________________________________
4. Mailing Address:_____________________________________________________________
5. City:____________________________ State:_______________ Zip____________________
6. Amount overpaid/underpaid:$___________________________________________________
7. For the period(s) of:___________________________________________________________
8. State full and complete reasons for the error(s) in reporting which resulted in the above listed
over/under payment:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
These figures are provided to the best of my knowledge and I understand that this form does not
restrict the Department of Revenue from performing an audit of my records.
Name (Please Print):____________________________________________________________
Signature:______________________________________________ Date:__________________
Title:____________________________________ Telephone Number:_____________________
_____________________________________________________________________________
(For Department Use Only)
DOR Comments:_______________________________________________________________
_____________________________________________________________________________
Postmark:_________________________________
Reviewed By:_______________________________________ Date:______________________
All amended returns covering the periods indicated above must accompany this form
Revised 11/2017
PRINT FOR MAILING
CLEAR FORM
SD EForm - 1784
V2
Complete and use the button at the end to print for mailing.
HELP
SUMMARY FOR AMENDING
Department of Revenue
MOTOR FUEL TAX RETURNS
Motor Fuel Tax
445 East Capitol Avenue
Pierre, SD 57501-3100
Please Type or Print:
1. License Number:_____________________________________________________________
2. Federal ID or Social Security Number:____________________________________________
3. Business Name:_____________________________________________________________
4. Mailing Address:_____________________________________________________________
5. City:____________________________ State:_______________ Zip____________________
6. Amount overpaid/underpaid:$___________________________________________________
7. For the period(s) of:___________________________________________________________
8. State full and complete reasons for the error(s) in reporting which resulted in the above listed
over/under payment:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
These figures are provided to the best of my knowledge and I understand that this form does not
restrict the Department of Revenue from performing an audit of my records.
Name (Please Print):____________________________________________________________
Signature:______________________________________________ Date:__________________
Title:____________________________________ Telephone Number:_____________________
_____________________________________________________________________________
(For Department Use Only)
DOR Comments:_______________________________________________________________
_____________________________________________________________________________
Postmark:_________________________________
Reviewed By:_______________________________________ Date:______________________
All amended returns covering the periods indicated above must accompany this form
Revised 11/2017
PRINT FOR MAILING
CLEAR FORM