Form B&L: MF-5 (2) "Petition for Diesel Fuel Tax Refund" - Alabama

What Is Form B&L: MF-5 (2)?

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

Form Details:

  • Released on May 1, 2020;
  • The latest edition provided by the Alabama 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 B&L: MF-5 (2) by clicking the link below or browse more documents and templates provided by the Alabama Department of Revenue.

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Download Form B&L: MF-5 (2) "Petition for Diesel Fuel Tax Refund" - Alabama

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A
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R
B&L: MF-5 (2)
LABAMA
EPARTMENT OF
EVENUE
Reset
B
& L
T
D
5/20
USINESS
ICENSE
AX
IVISION
M
F
S
OTOR
UELS
ECTION
P.O. Box 327540 • Montgomery, AL 36132-7540 • (334) 242-9608
www.revenue.alabama.gov
Petition For Diesel Fuel Tax Refund
(NO GASOLINE ALLOWED)
NAME
QUARTER ENDING
ADDRESS
FEIN OR SSN
CITY
STATE
ZIP CODE
PHONE NUMBER
(            )
Check Here
EMAIL ADDRESS
CONTACT PERSON
6
If New Address
INDICATE ORGANIZATION TYPE:
6
6
Gas District
Volunteer Fire Department
6
6
6
Water & Fire Authority
Charitable Organization
Other __________________________
PURCHASES OF DIESEL FUEL IN ALABAMA FOR WHICH THIS PETITION IS BEING FILED
VENDOR NAME AND ADDRESS
DATE OF PURCHASE
GALLONS
(IF SPACE IS INSUFFICIENT, CONTINUE ON REVERSE SIDE)
TAX REFUND COMPUTATION
1
1.  Total gallons listed above and on reverse side . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
X        $0.27
2.  Rate of refund per gallon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
3.  Amount of refund claimed (Line 1 multiplied by line 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
I hereby certify that to the best of my knowledge and belief the above petition is true and correct, that the diesel fuel claimed
thereon was purchased and paid for by the petitioner, and that said petitioner is entitled to such refund under the provisions
of Sections 40-9-9 through 40-9-13, 40-9-23, 40-9-35, 40-9-36, 11-22-13, 11-50-412, 11-88-16, 11-89-16, or 22-51-13, Code
of Alabama 1975.
Signature: _________________________________________________________________ Date: ____________________________
Title or Position: ______________________________________________________________________________________________
Records to clearly substantiate the above petition must be maintained by the applicant for a period of six years and must be
made available to the Alabama Department of Revenue or its authorized agents upon request. The statute of limitations is two
years from the date of purchase of fuel. A copy of receipts/invoices or a credit card report of purchases must be submitted
with the petition for refund. The receipts or reports must include the date of the purchase, name and location of vendor,
product type, invoice number, and number of gallons of fuel purchased.
A
D
R
B&L: MF-5 (2)
LABAMA
EPARTMENT OF
EVENUE
Reset
B
& L
T
D
5/20
USINESS
ICENSE
AX
IVISION
M
F
S
OTOR
UELS
ECTION
P.O. Box 327540 • Montgomery, AL 36132-7540 • (334) 242-9608
www.revenue.alabama.gov
Petition For Diesel Fuel Tax Refund
(NO GASOLINE ALLOWED)
NAME
QUARTER ENDING
ADDRESS
FEIN OR SSN
CITY
STATE
ZIP CODE
PHONE NUMBER
(            )
Check Here
EMAIL ADDRESS
CONTACT PERSON
6
If New Address
INDICATE ORGANIZATION TYPE:
6
6
Gas District
Volunteer Fire Department
6
6
6
Water & Fire Authority
Charitable Organization
Other __________________________
PURCHASES OF DIESEL FUEL IN ALABAMA FOR WHICH THIS PETITION IS BEING FILED
VENDOR NAME AND ADDRESS
DATE OF PURCHASE
GALLONS
(IF SPACE IS INSUFFICIENT, CONTINUE ON REVERSE SIDE)
TAX REFUND COMPUTATION
1
1.  Total gallons listed above and on reverse side . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
X        $0.27
2.  Rate of refund per gallon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
3.  Amount of refund claimed (Line 1 multiplied by line 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
I hereby certify that to the best of my knowledge and belief the above petition is true and correct, that the diesel fuel claimed
thereon was purchased and paid for by the petitioner, and that said petitioner is entitled to such refund under the provisions
of Sections 40-9-9 through 40-9-13, 40-9-23, 40-9-35, 40-9-36, 11-22-13, 11-50-412, 11-88-16, 11-89-16, or 22-51-13, Code
of Alabama 1975.
Signature: _________________________________________________________________ Date: ____________________________
Title or Position: ______________________________________________________________________________________________
Records to clearly substantiate the above petition must be maintained by the applicant for a period of six years and must be
made available to the Alabama Department of Revenue or its authorized agents upon request. The statute of limitations is two
years from the date of purchase of fuel. A copy of receipts/invoices or a credit card report of purchases must be submitted
with the petition for refund. The receipts or reports must include the date of the purchase, name and location of vendor,
product type, invoice number, and number of gallons of fuel purchased.
PURCHASES OF DIESEL FUEL IN ALABAMA FOR WHICH THIS PETITION IS BEING FILED
VENDOR NAME AND ADDRESS
DATE OF PURCHASE
GALLONS
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