Rmft 11 A Form PDF Details

The RMFT-11-A form is a comprehensive document issued by the Illinois Department of Revenue, catering specifically to individuals and entities seeking refunds for motor fuel tax paid in Illinois on or after January 1, 2001. This form serves as a crucial tool for those entitled to reclaim taxes on fuel used for various nonhighway purposes, agricultural endeavors, or specific industrial uses. Its detailed structure demands accurate reporting of the period covered by the claim, identification information including Federal employer identification number or Social Security number, and an exhaustive breakdown of fuel usage across different categories and activities. It meticulously guides claimants through the process of calculating their entitled refund based on gallons of gasoline and undyed diesel fuel consumed, adjusted by tax rates corresponding to each fuel type. Furthermore, the RMFT-11-A form requires descriptions of the motor fuel's application, whether for highway purposes or specialized operations like cultivation, manufacturing, or powering refrigeration units on semitrailers. Claimants must also list equipment used, sign under penalty of perjury attesting to the claim's accuracy, and comply with submission regulations to ensure proper processing. Designed to accommodate a broad spectrum of refund claims, this form embodies the Illinois Department of Revenue's commitment to systematic tax recovery while emphasizing the importance of precision and honesty in filings.

QuestionAnswer
Form NameRmft 11 A Form
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namesform rmft 11 a, rmft 11 a instructions, rmft 11, instructions for rmft 11 a

Form Preview Example

Illinois Department of Revenue

RMFT-11-A Illinois Motor Fuel Tax Refund Claim for tax paid on or after January 1, 2001

Step 1: Tell us the period covered by this claim

1 Write the period for which you are claiming a refund

From:__ __ /__ __ __ __

To:__ __ /__ __ __ __

 

Month/Year

Month/Year

Step 2: Identify yourself

2 ______________________________

3

Federal employer identification number:__ __ - __ __ __ __ __ __ __

Name

 

or

 

 

______________________________

 

Social Security number: __ __ __ - __ __ - __ __ __ __

Address

 

 

______________________________

4

Phone number: (____)______ - __________

City, state, ZIP

 

 

5If you were licensed as an Illinois distributor or supplier during

the claim period, write your motor fuel license number.

__ - __ __ __ __ __

Step 3: Figure your refund

Complete the columns below to list your tax-paid motor fuel gallons. Your refund claim must be based on the motor fuel you used during the claim period in Line 1. If you were not a licensed distributor or supplier, you may claim the gallons on which the tax was paid two years ago or less. Licensed distributors and suppliers may only claim the gallons on which the tax was paid one year ago or less.

Column A

Column B

Column C

Tax rate

Column D

Total gallons

Highway

Nonhighway

per gallon

Net refund

 

gallons

gallons

 

 

6 Gasoline (from Step 6)

__________________

-

_________________

= _________________

x

7 Undyed diesel fuel (from Step 7)

 

 

 

 

__________________

-

_________________

= _________________

x

19¢ (.19)

=

$______________

21 ½¢ (.215)

=

$______________

8 Add the amounts in Lines 6 - 7, Column D, and write the result. This is your total refund claim amount. =

$______________

________________

_______________

Official Use

Official Use

Step 4: Describe how you used the motor fuel listed in Step 3

9 What was the motor fuel used for? At what locations was it used? Describe in detail. Attach a separate sheet if needed.

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

Official use - do not write in this box

l___l___l___l___l___l___l___l___l

 

M M

D

D

Y

Y

Y

Y

 

RT

IA

CL

WA

 

 

 

 

 

 

I.D.

1

- Agriculture

11

- Comm MV

 

 

 

2

- Construction

12

- Airport

 

 

 

3

- Industrial

13

- Refrigeration

 

 

 

 

4

- Railroad

14

- Power Take-off

 

5

- Marine

 

15

- Unintentional mixing

6

- Lawn

 

16

- Testing

 

 

 

7

- Distributor

17

- Dual Taxation

 

8

- Supplier

18

- Loss

 

 

 

9

- Manufacture

19

- Tug/Spotter

 

10

- R & D

 

 

 

 

 

 

 

Step 5: Describe the motor fuel you used for highway purposes (from Step 3, Column B)

10

Number of miles traveled by motor vehicles

gasoline

_______________

undyed diesel fuel _______________

11

Number of gallons removed from storage

gasoline

_______________

undyed diesel fuel _______________

RMFT-11-A Page 1 of 4 (R-8/05)

This form is authorized as outlined by the Motor Fuel Tax Law. Failure to disclose this information could result in this form not being processed. This form has been approved by the Forms Management Center. IL-492-1542

Step 6: Describe the gasoline you used for nonhighway purposes

12Acres under cultivation

Beans

________________

Corn

________________

Hay

________________

Small grain

________________

13Acres of custom work (production and operation)_______________

14Number of gallons pumped

Gasoline

________________

Fuel oil

________________

LPG from a 300 - 500

 

gallon tank

________________

LPG from tanks larger

 

than 500 gallons

________________

15 Number of gallons used to

 

Clear timber

________________

Mix cement (PTO)

________________

Mix cement (non-PTO)

________________

Operate irrigation equipment

________________

Operate scavenger trucks (PTO)

________________

16Number of hours used for backhoe digging ________________

17Number of loads

Augering dry cement

____________________________________

Blowing dry cement

____________________________________

18Tons of dry fertilizer applied

Limestone

________________

Phosphate

________________

19Dry fertilizer

22Number of livestock maintained

Beef cattle

________________

Dairy cattle

________________

Poultry

________________

Sheep

________________

Swine

________________

23Other farm operations that are included in your refund claim

Acres of

Bluegrass planting

________________

Bushhogging

________________

Chisel plowing

________________

Chopping stalks

________________

Combining

________________

Cultivating

________________

Discing

________________

Insecticide sprayed

________________

Moldboard plowing

________________

Mowing

________________

Nurseries

________________

Orchards

________________

Planting

________________

Silage

________________

Spray chemicals applied

________________

Straw baling

________________

Spray fertilizer

________________

Replanting

________________

Reseeding

________________

Treatment for corn borers,

 

earthworms, or weeds

________________

Truck farming

________________

Bushels of

 

Tons applied

or

Acres of application

________________

Corn shelling

________________

________________

Tons of

 

 

Feed ground

________________

20Tons of liquid fertilizer applied

Mixed Nitrate

____________________________________ 24 Other nonhighway gasoline usage not identified above

____________________________________

(please detail)___________________________________________________________________________________________

21Acres to which liquid fertilizer was applied

Anhydrous ammonia

____________________________________

__________________________________________________________________________________________________________________

NH3

____________________________________

 

 

 

__________________________________________________________________________________________________________________

 

 

__________________________________________________________________________________________________________________

 

 

__________________________________________________________________________________________________________________

 

 

__________________________________________________________________________________________________________________

RMFT-11-A Page 2 of 4 (R-8/05)

Step 7: Describe the gallons of undyed diesel fuel you used during this claim period

25Number of gallons used by a commercial motor vehicle for any purpose other than operating the commercial motor vehicle upon the public highways. Note: This vehicle must be operated for both highway purposes and any purposes other than operating such vehicles on public highways.

26Number of gallons used to operate power take-off (PTO) equipment that is mounted onto or designed as an integral part of a transmission of a motor vehicle that is registered for highway purposes.

27Number of gallons used by a single unit self-propelled agricultural fertilizer implement, designed for on and off road use, equipped with flotation tires and specially adapted for the application of plant food materials or agricultural chemicals.

28Number of gallons used by a refrigeration unit that is permanently mounted to a semitrailer and has a solely dedicated fuel supply system.

29Number of gallons used by a unit of local government in its operation of an airport if the undyed diesel fuel is used directly in airport operations on airport property.

30Number of gallons used in a manufacturing process where undyed diesel fuel becomes a component part of a product or byproduct other than fuel or motor fuel, when the use of dyed diesel fuel results in a product that is unsuitable for its intended use.

31Number of gallons used for testing machinery and equipment in a manufacturing process wherein testing takes place on private property.

32Number of gallons used by a manufacturer on private property in the research and development of machinery or equipment intended for manufacture.

33Number of gallons of undyed diesel fuel which was unintentionally mixed with dyed diesel fuel. A minimum of 500 gallons of undyed diesel fuel per incident must be unintentionally mixed before a refund may be claimed by those who own or control the mixture.

34Number of gallons used by tugs and spotter equipment to shift vehicles or parcels on both private and airport property.

Note: Claimant must own both, tugs and spotter equipment and operate that equipment on both private and airport property.

Column 1

Column 2

Column 3

Total

Highway use

Nonhighway use

______________ - ______________ = ______________

______________ - ______________ = ______________

______________ - ______________ = ______________

______________ - ______________ = ______________

______________ - ______________ = ______________

______________ - ______________ = ______________

______________ - ______________ = ______________

______________ - ______________ = ______________

______________ - ______________ = ______________

______________ - ______________ = ______________

RMFT-11-A Page 3 of 4 (R-8/05)

Step 8: Itemize your equipment

34Complete the following list of equipment in detail. Use extra sheets if necessary.

EQUIPMENT USED

DESCRIPTION

MOTOR FUEL TYPE

GALLONS USED

Check appropriate column

 

Check appropriate column

 

 

 

 

 

Undyed

 

 

 

Auto

Truck

Tractor

Misc. Print the make, model, year, and horsepower

diesel

Gasoline

LPG

Tax paid

Step 9: Sign below

Under penalties of perjury, I state that I have examined this refund claim and, to the best of my knowledge, it is true, correct, and complete.

_______________________________________________________________________________________________

_____________________________

Signature

Title

Date

Step 10: Mail your refund claim

Mail your refund claim to:

MOTOR FUEL TAX REFUND SECTION

ILLINOIS DEPARTMENT OF REVENUE

PO BOX 19019

SPRINGFIELD IL 62794-9019

Reminders:

Please send us the original refund claim, plus one copy. Keep a copy for your records.

Purchase documentation must be submitted when requested.

RMFT-11-A Page 4 of 4 (R-8/05)

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Stage no. 1 of completing fillable form rmft 11 a

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Completing section 2 of fillable form rmft 11 a

3. This third stage is generally hassle-free - fill in all the empty fields in Step Describe the gasoline you, Number of livestock maintained, Beans Corn Hay Small grain, Beef cattle Dairy cattle Poultry, Acres of custom work production, Number of gallons pumped, Gasoline Fuel oil LPG from a, Number of gallons used to, Clear timber Mix cement PTO Mix, Number of hours used for backhoe, Other farm operations that are, in your refund claim Acres of, and Bluegrass planting Bushhogging in order to complete this segment.

fillable form rmft 11 a writing process clarified (portion 3)

4. It is time to fill in this next segment! Here you'll have all these Number of loads, Augering dry cement Blowing dry, Tons of dry fertilizer applied, Bluegrass planting Bushhogging, Limestone Phosphate, earthworms or weeds, Truck farming, Dry fertilizer, Tons applied, Corn shelling, Bushels of, Acres of application, Tons of, Tons of liquid fertilizer applied, and Mixed Nitrate empty form fields to complete.

Bluegrass planting Bushhogging, Limestone Phosphate, and Tons of dry fertilizer applied in fillable form rmft 11 a

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Writing section 5 of fillable form rmft 11 a

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