Form Mvd 10964 – Fill Out and Use This PDF

Enter total from all pages here and on line 1.

Enter total from all pages here and on line 2.

Enter total from all pages here and on line 3.

Enter total of Column F, all pages,here and on line 4.

Weight Distance Tax Number:

Name

Street / Box

City, State, Zip

Quarter ending (mm-dd-ccyy)

0 7 - ___ ___ ___ ___ ___ ___ - 0 0 ___

1 Weight distance miles

2 Port of Entry miles paid

3Net Weight distance miles

4 Weight distance tax due

5 Penalty

1

2

3

4

5

6

7

Under penalty of perjury, I declare that I have examined this return including any accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete.

8

MVD - 10964 Rev. 11/06

State of New Mexico - Taxation and Revenue Department

Motor Vehicle Division - Commercial Vehicle Bureau

WEIGHT DISTANCE TAX RETURN - LONG FORM

SUPPLEMENTAL SCHEDULE

Page ____ of _____

NAME

WEIGHTDISTANCE TAXNUMBER

MVD - 10964 Rev. 11/06

State of New Mexico - Taxation and Revenue Department

Motor Vehicle Division - Commercial Vehicle Bureau

WEIGHT DISTANCE TAX RETURN - LONG FORM

Who Must File: Registrants, owners and operators of all motor vehicles having a declared gross weight or gross vehicle weight in excess of 26,000 pounds and who are using highways in this state are subject to the weight distance tax for the use of the highways of New Mexico and must file and pay the tax due. File and pay the taxdueusing FormMVD10964,NewMexicoWeightDistanceTax Return-Long Form.

Instructions: Enter the month, day and year of the last day of the reportingperiod.Areportperiodbeginsonthefirstdayofacalendar quarter and ends on the last day of the calendar quarter. Enter the weightdistancetaxnumber,federalemployeridentificationnumber thenameandaddressoftheregistrant,owneroroperator.Checkthe amended report box if you are amending a return previously filed.

Column A. Enter the weight class code from the table below that corresponds to the declared weight class of the motor vehicles(s) that you operate on New Mexico highways. The declared weight class of the vehicle is the highest gross vehicle weight or combined gross vehicle weight declared for registration purposes. Note: It is unlawful for any motor vehicle to be operated on New Mexico highways at a gross vehicle weight higher than the declared gross weight. Report one weight class per row, and a separate row if reportingaone-wayhaul millrateandafullhaulmillrateforthesame weight class. Do not combine one-way haul and full haul miles on the same line. See the "one-way haul" definition later in these instructions.

Mark the next column, if the miles reported are reported at a "one- way" haul rate, otherwise leave blank.

To qualify for a One-Way Haul rate, the motor vehicle must (1) customarily be used for one-way hauls; (2) have traveled 45% or more miles for the registration year empty of all load; and (3) be classified as a one-way hauler by the registrant, owner or operator whohasmadeaswornapplicationtothedepartmenttobeclassified as a one-way hauler for the registration year.

ColumnB. Weightdistancemiles:Enterthetotalmilestraveledin New Mexico during the report period. Enter the total of Column B from all pages on line 1.

Column C. Port of Entry miles Paid: Enter the total New Mexico MilespaidataPortofEntry.RetainthePortofEntryreceiptsinyour records. Enter the total of Column C from all pages on line 2.

Column D. Net Weight Distance Miles: Subtract Column C from Column B and enter in Column D. Enter the total of Column D from all pages on line 3.

ColumnE. MillRate:Enterthefullorone-wayhaulmillratefromthe table below that corresponds to the weight class code reported in ColumnA.

ColumnF.TaxDue:MultiplyColumnDbyColumnEandenterin Column F. Enter the total of Column F from all pages on line 4.

Line 2. Penalty. Add penalty if you fail to file timely or to pay the amountonline4whendue.Calculatethepenaltybymultiplyingthe unpaid amount on line 4 by 2%, then by the number of months or partial months for which the return or payment is late, not to exceed 10%ofthetaxdue.Penaltyforfailuretofilemaynotbelessthan$5.00.

Line 3. Interest. Add interest if the amount on line 4 was not paid by the due date. Calculate interest at a rate of .041% of the unpaid amountforeachdaythepaymentislate.Theformulaforcalculating dailyinterestis:Taxduex.00041xnumberofdayslate.(Theannual interest is 15% per year).

Line 7. Enter the sum of lines 4, 5 and 6.

Line 8. Enter amount paid.

Sign and date the return.