Form Ifta 100 Mn – Fill Out and Use This PDF

Licensee IFTA identification number

CT

Name

Street address

IFTA Quarterly Fuel Use Tax Return

Address change

No operation in any jurisdiction

Cancel license

Amended return

fold

- - - -

here

fold

- - - -

here

General Information

Who Must File - Anyone holding a license under the International Fuel Tax Agreement (IFTA) is required to file, on

aquarterly basis Form IFTA-100, I FT A Quarterly Fuel U se T ax Return, and Form IFTA-101, I FT A Quarterly Fuel U se T ax

S chedule for each fuel type. These forms are preprinted with your taxpayer identification number, name, address, fuel types and traveled jurisdictions and are mailed to you. (IFTA-100-MN, IFTA Quarterly Fuel Use Tax Return and IFTA-101-MN, IFTA Quarterly Fuel Use Tax Schedule, are the manual versions of these forms that require you to enter all pertinent information and should only be used when the preprinted version is unattainable.)

Form IFTA-100 summarizes the amount of tax due or the amount to be credited for the various fuel types computed on each Form IFTA-101 and is used to determine the total amount due/credit, including any appropriate penalty and interest.

U.S./METRIC CONVERSION FACTORS:

one liter = 0.2642 gallons one gallon = 3.785 liters one mile = 1.6093 kilometers one kilometer = 0.62137 miles

Instructions

Enter the ending date of the quarter covered by this return.

Enter your licensee IFTA identification number. This is your federal employer identification number, social security number or other jurisdiction assigned identification number as it appears on your IFTA License.

Enter your legal name as it appears on your IFTA license and complete mailing address.

Address Change - Mark X in this box if this address is your new or corrected address.

No Operation - Mark X in this box if you did not operate a qualified motor vechicle(s) in any jurisdiction including your base jurisdiction during the quarter. Sign this report and mail to the address indicated on the report.

Cancel License - Mark X in this box if you are filing a final return and requesting your license be canceled. Complete this return for your operations during the quarter and return your IFTA license and any unused decals to the address on your license. Destroy any used decals.

Amended Return - Mark X in this box if this return corrects a previous return. Indicate the quarter and year of the return you are correcting. The amended return should show the correct figures for that quarter - not the difference. An explanation of the changes must accompany the amended return.

Line Instructions

Enter any credit amounts in brackets.

Line 1 - Enter the total amount from column Q on the front of Form IFTA-101-MN for diesel fuel.

Line 2 - Enter the total amount from column Q on the front of Form IFTA-101-MN for motor fuel gasoline.

Line 3 - Enter the total amount from column Q on the front of Form IFTA-101-MN for ethanol.

Line 4 - Enter the total amount from column Q on the front of Form IFTA-101-MN for propane (LPG).

Line 5 - Enter the total amount from column S of the worksheet on the back of Form IFTA-101-I-MN for all other fuel types.

carried forward for more than eight quarters (two years) from the quarter earned.

Signature - The return must be signed and dated by the owner (if an individual business), a partner (if a partnership or a limited liability partnership), a member (if a limited liability company), or (if a corporation) by the president, treasurer, chief accounting officer, or any other person specifically authorized to act on behalf of a corporation. The fact that an individual's name is signed on the certification shall be prima facie evidence that the individual is authorized to sign and certify the return on behalf of the business.

MAILING INSTRUCTIONS

1.Attach check or money order payable to

COMMISSIONER OF REVENUE SERVICES.

2.Include on your check or money order your identification

number, Form IFTA- 100- MN and the period covered by this return.

3.Place this form (this side up) on top of the IFTA- 101- MN schedule(s) you are returning.

For additional forms or information, see the back of

Form IFTA-101 -I-MN, Ins tructions for comple ting Form IFTA-101 -MN.

Mail your return to the

IFTA Processing Center at this address.

STATE OF CONNECTICUT

PO BOX 22075

ALBANY NY 12201-2075

F

Jurisdiction

G

Rate Code

K

Taxable Gallons

(col. I : J)

L

Tax Paid

Gallons

(See Instructions)

M

Net Taxable

Gallons

(col. K - L)

N

Tax Rate

O

Tax (Credit) Due

(col. M x N (Tax) ) (col. K x N (Surch) )

P

Interest

Due

Q

Total Due

(col. O + P)

Subtotals

Subtotals from back

Totals

Important Note: When listing additional jurisdictions and more space is needed, use the back of this form.

IFTA-101 (4/06) (back)

F

Jurisdiction

G

Rate Code

H

Total Miles

(See Instructions)

I

Taxable

Miles

(See Instructions)

J

MPG

from E on front

K

Taxable

Gallons

(col. I : J)

L

Tax Paid

Gallons

(See Instructions)

M

Net Taxable

Gallons

(col. K - L)

N

Tax Rate

O

Tax (Credit) Due

(col. M x N (Tax)) (col. K x N (Surch))

P

Interest

Due

Q

Total Due

(col. O + P)

Aseparate Form IFTA-101-MN must be used for each fuel type. Refer to Form IFTA-105, Final Fuel U se T ax Rate and Rate Code T able 1, when completing schedules for Diesel, Motor Fuel Gasoline, Ethanol, Propane and CNG. For all other fuel types refer to the IFTA-105, Final Fuel U se T ax Rate and Rate Code

T able 2. Check the appropriate box for the fuel type you are reporting. When reporting a fuel other than those listed, check the box next to the blank line and enter in the Fuel Type Code and Fuel Type as shown on the back of these instructions.

Enter the quarter ending date of the period covered by this return.

Enter your licensee IFTA identification number. This is your federal employer identification number, social security number or other jurisdiction assigned identification number as it appears on your IFTA license.

Enter your legal name as it appears on your IFTA License.

(A)Total IFTA Miles - Enter the total miles traveled in IFTA jurisdictions by all qualified motor vehicles in your fleet using the fuel type indicated on each form/schedule (total from column H). Report all miles traveled whether the miles are taxable or nontaxable. Round mileage to the nearest whole miles

(e.g., 1234.5 = 1235).

(B)Total NON- IFTA Miles - Enter the total miles traveled in

non-IFTA jurisdictions by all qualified motor vehicles in your fleet using the fuel type indicated on each form/schedule. Report all miles traveled whether the miles are taxable or nontaxable. Round mileage to the nearest whole mile (e.g., 1234.5 = 1235).

(C)Total Miles - Add the amount in item (A) and the amount in item (B) to determine total miles traveled by all qualified motor vehicles in your fleet.

(D)Total Gallons - Enter the total gallons of fuel placed in the propulsion tank in both IFTA and non-IFTA jurisdictions for all qualified motor vehicles in your fleet using the fuel type indicated. Round gallons to the nearest whole gallon

(e.g., 123.4 = 123).

(E)Average Fleet MPG - Divide item (C) by item (D). Round to 2 decimal places (e.g., 4.567 = 4.57).

Column F - Enter the name of each IFTA jurisdiction that you operated in during the period. Enter the jurisdiction's name on two(2) consecutive lines if the traveled jurisdiction administers a surcharge1in addition to their regular fuel tax. Enter the jurisdiction's two letter abbreviation from Form IFTA-105 or IFTA-105.1 for the quarter you are preparing.

Column G - Enter the rate code of the appropriate fuel type for each IFTA jurisdiction from Form IFTA-105 or IFTA-105.1 for the quarter you are preparing.

Column H - Enter the total miles traveled (taxable and nontaxable) in each IFTA jurisdiction for this fuel type only. Enter '0' on a surcharge line. Round mileage to the nearest whole miles (e.g., 1234.5 = 1235).

Column I - Enter the IFTA taxable miles for each IFTA jurisdiction. Do not include fuel use trip permit miles. Enter '0' on a surcharge line. Round mileage to the nearest whole miles (e.g., 1234.5 = 1235).

Column J - Enter your average fleet miles per gallon (mpg) from item (E) above. Enter '0' on a surcharge line.

1Jurisdictions with surcharge: Indiana, Kentucky and Virginia. IFTA- 101- I- MN (4/06)

Column K - Divide the amount in column I by the amount in column J to determine the total taxable gallons of fuel consumed in each IFTA jurisdiction. For surcharge1 taxable gallons, enter the taxable gallons from the same jurisdiction's fuel use tax line, Column K. Round gallons to the nearest whole gallon

(e.g., 123.4 = 123.).

Column L - Enter the total tax-paid gallons of fuel purchased and placed in the propulsion tank of a qualified motor vehicle in each IFTA jurisdiction. (Enter "0" in column L if this line represents a surcharge, since a surcharge cannot be prepaid.) Keep your receipts for each purchase claimed. When using bulk storage, report only tax-paid gallons removed for use in your qualified motor vehicles. Fuel remaining in storage cannot be claimed until it is used.

Round gallons to the nearest whole gallon (e.g., 123.4 = 123).

Column M - Subtract the amounts in column L from column K for each jurisdiction. Enter '0' on a surcharge line.

-If column K is greater than column L, enter the taxable gallons.

-If column L is greater than column K, enter the credit gallons. Use brackets to indicate credit gallons.

Column N - Enter the rate for the appropriate fuel type from Form IFTA-105 or IFTA-105.1 for the quarter you are preparing. Where a surcharge1is applicable, enter the appropriate surcharge rate from Form IFTA-105 or IFTA-105.1 for the quarter you are preparing.

Column O - Multiply the amount in column M by the tax rate for that jurisdiction in column N to determine the tax or credit. Enter any credit amount in brackets. Where a surcharge1is applicable, multiply the amount in Column K by the surcharge rate for that jurisdiction in Column N.

Column P - If you file late, compute interest on any tax due for each jurisdiction for each fuel type indicated on each form/schedule. Interest is computed on tax due from the due date of the return until the date payment is received. Interest is computed at 1% per month or part of a month, to a maximum of 12% per year. Returns must be postmarked no later than the last day of the month following the end of the quarter to be timely.

Column Q - For each jurisdiction add the amounts in column O and column P, and enter the total dollar amount due or credit amount. Enter any credit amount in brackets.

Subtotals - Add the amounts in columns H, O, P and Q on the front of the schedule and enter on the S ubtotals line in the appropriate columns. Add the amounts in columns H, O, P and Q on the back of the schedule and enter in the applicable columns on the S ubtotals line below. Enter these amounts in the applicable columns on the front of the schedule on the

S ubtotals from back line.

Totals - Add the S ubtotals and the S ubtotals from back to determine the T otals. The total in column Q is the difference of all credits and taxes due for all jurisdictions. Transfer the T otals from Column Q for each fuel type reported to the corresponding line of Form IFTA-100-MN. For all other fuel types, add the S ubtotals and the S ubtotals from back, and transfer the T otal from column Q for each of these fuel types to the corresponding line in column S of the worksheet on the back of these instructions.

Make a copy of this return for your records.