Form 72A089 "Licensed Gasoline Dealer's Monthly Report" - Kentucky

What Is Form 72A089?

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

Form Details:

  • Released on July 1, 2007;
  • The latest edition provided by the Kentucky 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 printable version of Form 72A089 by clicking the link below or browse more documents and templates provided by the Kentucky Department of Revenue.

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Download Form 72A089 "Licensed Gasoline Dealer's Monthly Report" - Kentucky

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72A089 (7-07)
FOR DEPARTMENT USE ONLY
LICENSED GASOLINE DEALER’S
Commonwealth of Kentucky
MONTHLY REPORT
5 4
__ __ __ __ __ __ / __ __ / __ __ / __ __
DEPARTMENT OF REVENUE
Account Number
Tax
Mo.
Yr.
➤ See Instructions on Reverse
Name and Address of Dealer
Check here for address change
Gasoline Dealer's Number GL__ __ __ __
Federal
Employer ID Number __ __ – __ __ __ __ __ __ __
Report for (mm/yy) _________________________________
(
)
Telephone Number __________________________________
Check Here if EFT Payment
(
)
Contact Person
Fax Number _______________________________________
PART I—Computation of Gasoline Gallons Subject to Tax
Attach
COLUMN A
COLUMN B
COLUMN C
RECEIPTS
Schedule
In gallons
In gallons
In gallons
1. Gasoline purchased in Kentucky (Form 72A179) ..................................
2
2. a. Gasoline sold for import into Kentucky
(Supplier's Report) (Form 72A178) ....................................................
5D
b. Gasoline imported into Kentucky from other states (Form 72A179)
3
c. Total imports (add lines 2a and line 2b) .............................................
3. Gasoline disbursements from terminal storage (Form 72A179) ...........
2A
4. Receipts of unreported alcohol or other additives (Form 72A179) ......
2B
5. Total gasoline received (add lines 1, 2c, 3 and 4) ................................
DEDUCTIONS
6. Gasoline exported from Kentucky (Form 72A178) ...............................
7
7. Gasoline sold to Kentucky licensed dealers (Form 72A178) ................
6
8. Gasoline sold to U.S. government (Form 72A178) ................................
8
9. Gasoline lost through accountable losses (Approved Form 72A078) ..
10. Total gasoline deductions (add lines 6, 7, 8 and 9) ..............................
11. Total gasoline gallons subject to tax (line 5 minus line 10) ..........................................................................................................
PART II—Tax Computation
12. Gross tax liability (line 11 times rate per gallon) .............................................................................................................................
$
13. Tax rate adjustment for gasoline gallons inventory held in wholesale bulk storage on the last day of the period
(rate increase (decrease) __________ times __________ gallons) ................................................................................................
$
14. Tax due after tax rate adjustment (line 12 plus line 13) ...................................................................................................................
$
15. Nonhighway dealer credits
a. Sales of gasoline for agicultural purposes (Form 72A178)
(gallons on Schedule 10I _________________ times tax rate) .......................................................
$ (
)
16. Total nonhighway dealer credits (total of line 15) ............................................................................................................................
$ (
)
17. Tax due after credits (line 14 minus line 16) .....................................................................................................................................
$
18. Dealer compensation allowance (2¼% of line 17 if report and payment are timely submitted) ...................................................
$ (
)
19. Net tax due after allowable compensation (line 17 minus line 18) ..................................................................................................
$
20. Credit(s) for previous payments and other authorized credits (attach a copy of authorization) ...................................................
$ (
)
21. Total tax due (overpayment) (line 19 minus line 20) ......................................................................................................................
$
PART III—Statistical Gallons
1.
1. Gasoline imported into Kentucky (Kentucky tax paid to supplier) Form 72A179 (Schedule 1).
2.
2. Fuel-grade alcohol gallons blended or purchased for blending with gasoline during the above report period.
Make check payable to: KENTUCKY STATE TREASURER.
IMPORTANT NOTICE ➤
Mail report and check to: KENTUCKY DEPARTMENT OF REVENUE, FRANKFORT, KENTUCKY 40619.
I, the undersigned, a principal officer of the above-named licensee, have examined this report and it is, to the best of my knowledge and belief, a true,
correct and complete report.
Signature
Print Name
Title
Date
72A089 (7-07)
FOR DEPARTMENT USE ONLY
LICENSED GASOLINE DEALER’S
Commonwealth of Kentucky
MONTHLY REPORT
5 4
__ __ __ __ __ __ / __ __ / __ __ / __ __
DEPARTMENT OF REVENUE
Account Number
Tax
Mo.
Yr.
➤ See Instructions on Reverse
Name and Address of Dealer
Check here for address change
Gasoline Dealer's Number GL__ __ __ __
Federal
Employer ID Number __ __ – __ __ __ __ __ __ __
Report for (mm/yy) _________________________________
(
)
Telephone Number __________________________________
Check Here if EFT Payment
(
)
Contact Person
Fax Number _______________________________________
PART I—Computation of Gasoline Gallons Subject to Tax
Attach
COLUMN A
COLUMN B
COLUMN C
RECEIPTS
Schedule
In gallons
In gallons
In gallons
1. Gasoline purchased in Kentucky (Form 72A179) ..................................
2
2. a. Gasoline sold for import into Kentucky
(Supplier's Report) (Form 72A178) ....................................................
5D
b. Gasoline imported into Kentucky from other states (Form 72A179)
3
c. Total imports (add lines 2a and line 2b) .............................................
3. Gasoline disbursements from terminal storage (Form 72A179) ...........
2A
4. Receipts of unreported alcohol or other additives (Form 72A179) ......
2B
5. Total gasoline received (add lines 1, 2c, 3 and 4) ................................
DEDUCTIONS
6. Gasoline exported from Kentucky (Form 72A178) ...............................
7
7. Gasoline sold to Kentucky licensed dealers (Form 72A178) ................
6
8. Gasoline sold to U.S. government (Form 72A178) ................................
8
9. Gasoline lost through accountable losses (Approved Form 72A078) ..
10. Total gasoline deductions (add lines 6, 7, 8 and 9) ..............................
11. Total gasoline gallons subject to tax (line 5 minus line 10) ..........................................................................................................
PART II—Tax Computation
12. Gross tax liability (line 11 times rate per gallon) .............................................................................................................................
$
13. Tax rate adjustment for gasoline gallons inventory held in wholesale bulk storage on the last day of the period
(rate increase (decrease) __________ times __________ gallons) ................................................................................................
$
14. Tax due after tax rate adjustment (line 12 plus line 13) ...................................................................................................................
$
15. Nonhighway dealer credits
a. Sales of gasoline for agicultural purposes (Form 72A178)
(gallons on Schedule 10I _________________ times tax rate) .......................................................
$ (
)
16. Total nonhighway dealer credits (total of line 15) ............................................................................................................................
$ (
)
17. Tax due after credits (line 14 minus line 16) .....................................................................................................................................
$
18. Dealer compensation allowance (2¼% of line 17 if report and payment are timely submitted) ...................................................
$ (
)
19. Net tax due after allowable compensation (line 17 minus line 18) ..................................................................................................
$
20. Credit(s) for previous payments and other authorized credits (attach a copy of authorization) ...................................................
$ (
)
21. Total tax due (overpayment) (line 19 minus line 20) ......................................................................................................................
$
PART III—Statistical Gallons
1.
1. Gasoline imported into Kentucky (Kentucky tax paid to supplier) Form 72A179 (Schedule 1).
2.
2. Fuel-grade alcohol gallons blended or purchased for blending with gasoline during the above report period.
Make check payable to: KENTUCKY STATE TREASURER.
IMPORTANT NOTICE ➤
Mail report and check to: KENTUCKY DEPARTMENT OF REVENUE, FRANKFORT, KENTUCKY 40619.
I, the undersigned, a principal officer of the above-named licensee, have examined this report and it is, to the best of my knowledge and belief, a true,
correct and complete report.
Signature
Print Name
Title
Date
INSTRUCTIONS
WHO MUST FILE
Each licensed gasoline dealer must file this report with all applicable supporting schedules
each month. This report is required even though there may be no tax-free gallons to list as
received or distributed.
WHEN TO FILE
The report is due on or before the 25th day of the month following the month covered by the
report. Example: The January report is due on February 25. Failure to timely file a monthly
report will result in loss of compensation (line 18) and imposition of late filing penalties.
PAYMENT
Payment of the tax due must accompany the report. The monthly payment must be made by
Electronic Funds Transfer to Kentucky State Treasurer. Failure to timely remit all gasoline
tax due will result in loss of compensation (line 18) and imposition of late pay penalties and
interest.
EXTENSION OF TIME
Notify the Motor Fuels Tax Compliance Section in the event you need to extend the filing date.
Payment of not less than 95 percent of the total tax liability is required to extend the filing date
of the gasoline monthly report. If the estimated payment is filed timely then the completed
72A089 and support schedules with any remaining tax payment is due on the last day of the
month.
TAX RATE
The gasoline tax rate is set quarterly and is effective for a quarterly period. Notification of the
tax rate is mailed 20 days before the beginning of each calendar quarter. Example: Dealers are
notified by March 10 of the tax rate effective for April, May and June.
RECORDS RETENTION
Licensed dealers must keep all records relating to the receipt and distribution of gasoline for
a period of five years. Such records include invoices, bills of lading, delivery tickets, meter
readings and any other documents relating to the dealer’s motor fuel activity.
PETROLEUM STORAGE
TANK ENVIRONMENTAL
ASSURANCE FEE
MONTHLY REPORT
Each licensed gasoline dealer must also file Form 72A011, Petroleum Storage Tank
Environmental Assurance Fee Monthly Report. The fee computed on gasoline gallons is based
on taxable gasoline shown on line 11 of this report.
STATISTICAL GALLONS
Part III, line 1 gallons are the total gallons of gasoline purchased at the terminal rack for import
into Kentucky and on which the Kentucky gasoline excise tax was precollected by the
supplier. Attach Form 72A179 (Schedule 1).
Part III, line 2 information is provided to the Kentucky Transportation Cabinet for use in
compiling data required to be provided to the Federal Highway Administration of the U.S.
Government.
ASSISTANCE AND
INFORMATION
Telephone
(502) 564-3853
Address Correspondence
Motor Fuels Tax Section
Department of Revenue
P.O. Box 1303, Station 63
Frankfort, KY 40602-1303
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