Form 96-0466 "Motor Vehicle/Aviation Fuel Refund Application" - Arizona

What Is Form 96-0466?

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

Form Details:

  • Released on June 1, 2020;
  • The latest edition provided by the Arizona Department of Transportation;
  • 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 96-0466 by clicking the link below or browse more documents and templates provided by the Arizona Department of Transportation.

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Download Form 96-0466 "Motor Vehicle/Aviation Fuel Refund Application" - Arizona

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Mail Drop 521M
MOTOR VEHICLE/AVIATION FUEL
Fuel Tax Refund Compliance Unit
REFUND APPLICATION
Arizona Department of
Transportation
• Complete online or in black ink
PO Box 2100
azdot.gov
96-0466 R06/20
Clear
• Mail to the address above
Phoenix AZ 85001-2100
Checks are now being mailed directly from the Arizona Department of Administration and we are no longer able to attach a copy of the refund
application to the check. Please keep a copy of your application for your records.
Refund Period Beginning Date *
Refund Period Ending Date *
Federal EIN
Refund Account Number
G –
Business Type
 Aggregate
 Construction
 Farm
 Other:
 Golf Course
 Government
 Transportation
Applicant Name
Business Phone
(
)
Doing Business As (DBA)
Refund Mailing Address
Check if changed City
State
Zip
Contact Person Name
Contact Person Phone
Contact Email
(
)
A person or entity that is licensed in Arizona as a supplier, restricted distributor, IFTA carrier or a use fuel vendor has 3 years from the date the
fuel was purchased to file the refund request.
A person or entity that is not required to be licensed as a supplier, restricted distributor, IFTA carrier or a use fuel vendor has 6 months from the
date the fuel was purchased to file the refund request.
If the claim is less than $10, only one request may be submitted for any one person or entity in a consecutive 6-month period.
All of the following completed, legible documents must be submitted with this application:
 Fuel purchase invoice copies
 Fuel Refund Equipment List, 96-0161
 Flight Log (detailing agricultural purpose of use)
 Motor Vehicle Fuel Log Summary Schedule, 96-0466A
 Aviation Fuel Log Summary Schedule, 96-0466B for each aircraft.
ADOT Use
Refund Code
Total Gallons Claimed **
Tax Rate
Amount
OH/GG
UN11
x $0.18
0
OH
UN21
x $0.18
0
AV13
UN31
x $0.13
0
AV05
AF11
x $0.05
0
Total Refund Due *
I certify that the Arizona taxes have been paid on all of the gallons claimed above. The original, unaltered invoices (and supporting documents)
for the gallons claimed will be maintained for three years.
Printed Name
Title
Signature (must be original, wet signature)
Date
Must be signed by the licensee or an authorized officer of the business. All other signatures require a notarized power of attorney.
*
Refund Period dates must match Refund Period dates indicated on Motor Vehicle Fuel Log Summary Schedule, form #96-0466A and/or Aviation Fuel Log
Summary Schedule, form #96-0466B
**
Transfer totals from Motor Vehicle Fuel Log Summary Schedule, 96-0466A and/or Aviation Fuel Log Summary Schedule, 96-0446B
ADOT Use
Reviewer
Approved
Approval Date
Postmark Date
Compliance
 Yes
 No
Comments
Date Entered
Entered By
QTRFR Verified
QTRFR Verified Date Claim Number
Receipts
Comments
Mail Drop 521M
MOTOR VEHICLE/AVIATION FUEL
Fuel Tax Refund Compliance Unit
REFUND APPLICATION
Arizona Department of
Transportation
• Complete online or in black ink
PO Box 2100
azdot.gov
96-0466 R06/20
Clear
• Mail to the address above
Phoenix AZ 85001-2100
Checks are now being mailed directly from the Arizona Department of Administration and we are no longer able to attach a copy of the refund
application to the check. Please keep a copy of your application for your records.
Refund Period Beginning Date *
Refund Period Ending Date *
Federal EIN
Refund Account Number
G –
Business Type
 Aggregate
 Construction
 Farm
 Other:
 Golf Course
 Government
 Transportation
Applicant Name
Business Phone
(
)
Doing Business As (DBA)
Refund Mailing Address
Check if changed City
State
Zip
Contact Person Name
Contact Person Phone
Contact Email
(
)
A person or entity that is licensed in Arizona as a supplier, restricted distributor, IFTA carrier or a use fuel vendor has 3 years from the date the
fuel was purchased to file the refund request.
A person or entity that is not required to be licensed as a supplier, restricted distributor, IFTA carrier or a use fuel vendor has 6 months from the
date the fuel was purchased to file the refund request.
If the claim is less than $10, only one request may be submitted for any one person or entity in a consecutive 6-month period.
All of the following completed, legible documents must be submitted with this application:
 Fuel purchase invoice copies
 Fuel Refund Equipment List, 96-0161
 Flight Log (detailing agricultural purpose of use)
 Motor Vehicle Fuel Log Summary Schedule, 96-0466A
 Aviation Fuel Log Summary Schedule, 96-0466B for each aircraft.
ADOT Use
Refund Code
Total Gallons Claimed **
Tax Rate
Amount
OH/GG
UN11
x $0.18
0
OH
UN21
x $0.18
0
AV13
UN31
x $0.13
0
AV05
AF11
x $0.05
0
Total Refund Due *
I certify that the Arizona taxes have been paid on all of the gallons claimed above. The original, unaltered invoices (and supporting documents)
for the gallons claimed will be maintained for three years.
Printed Name
Title
Signature (must be original, wet signature)
Date
Must be signed by the licensee or an authorized officer of the business. All other signatures require a notarized power of attorney.
*
Refund Period dates must match Refund Period dates indicated on Motor Vehicle Fuel Log Summary Schedule, form #96-0466A and/or Aviation Fuel Log
Summary Schedule, form #96-0466B
**
Transfer totals from Motor Vehicle Fuel Log Summary Schedule, 96-0466A and/or Aviation Fuel Log Summary Schedule, 96-0446B
ADOT Use
Reviewer
Approved
Approval Date
Postmark Date
Compliance
 Yes
 No
Comments
Date Entered
Entered By
QTRFR Verified
QTRFR Verified Date Claim Number
Receipts
Comments