Transporters Monthly Tax Return {SF-401}

Indiana Department of Revenue State Form 46287 (R/12-05) SF-401 Transporter's Monthly Tax Return Due date is the 25th of the following month. For the month of: 20 Name of License Holder (As indicated on License) Mailing Address (Street or P.O. Box Number) City or Town License Number State Zip Code Telephone Number Motor Carrier/IFTA Number Federal Identification Number From Schedule Net Gallons Column A Column B Special Fuel Gasoline (Dyed and Clear (Gasoline, Diesel Fuel, Bio and Gasohol) Biodiesel) Column C Other Products (Jet Fuel, Kerosene) 1. Total gallons of fuel loaded from an Indiana terminal or bulk plant and delivered to another state. 2. Total gallons of fuel loaded from an out-of-state terminal or bulk plant and delivered into Indiana. 3. Total gallons of fuel loaded from an Indiana terminal or bulk plant and delivered within Indiana. 4. Total gallons of fuel transported (Add lines 1, 2, and 3). 1A 2A 3A Transporter's Schedule of Deliveries Schedules 1A, 2A and 3A must be attached to this report Mail Return To: Indiana Department of Revenue, P.O. Box 6080, Indianapolis, IN 46206-6080 Under penalty of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is true, correct, and complete. I further declare that complete and proper records are on file at the address indicated above for all fuel reported on this return. Taxpayer or Authorized Agent Typed or Printed Name Date Signed Title Telephone Number ( ) Important! A return must be filed each month, within 25 days following the last day of the month being reported. Failure to submit this report could result in a civil penalty of $1,000 for each violation. American LegalNet, Inc. www.FormsWorkflow.com Instructions for Completing Fuel Transporter's Monthly Tax Return Schedule SF-401 Who should file this return? Schedule of Deliveries Schedules 1A, 2A and 3A Every person who transports fuel from a point outside Schedule 1A - Exports: This schedule is to be completed Indiana to a point inside Indiana or from a point inside Indiana when transporting fuel from a point inside Indiana to a point to a point outside Indiana by truck, barge, rail and/or pipeline outside of Indiana. This reporting requirement is not required is required to file this return. for exports delivered by vehicles with a capacity of less than 5,400 gallons. Exports in vehicles with a capacity greater When is the return due? than 5,400 gallons would be reported as follows: The Fuel Transporter's Monthly Tax Return, Form SF-401, 1) Loads/Deliveries to a single location greater than 500 and supporting schedules are due by the 25th day of the gallons must be itemized on Schedule 1A. All information month following the month for which the return is being filed. must be completed for each of these transactions. Example: A return for the reporting period of January is due by the 25th of February. 2) Loads/Deliveries to a single location of 500 gallons or less may be grouped together and reported as "Various." How do I complete the SF-401? Schedule 2A - Imports: This schedule is to be completed Indicate at the top of the return the reporting period for which when transporting fuel from a point outside of Indiana to a you are filing. Enter your company's identifying information point inside Indiana. This reporting requirement includes all as indicated on your Indiana Fuel License. vehicles, regardless of capacity. Each load/delivery imported must be listed regardless of the number of gallons. Line 1 Enter the total gallons of fuel transported by you to another state from Schedule 1A-Exports. Schedule 3A - In-State Transfers: This schedule should be completed when transporting fuel from a point starting Line 2 Enter the total gallons of fuel transported by you inside Indiana to a point ending in Indiana. This reporting from another state into Indiana from attached requirement is not required for vehicles with a capacity of Schedule 2A - Imports. less than 5,400 gallons. Each load/delivery imported in a vehicle over 5,400 gallons must be listed regardless of the Line 3 Enter the total gallons of fuel loaded from an Indiana number of gallons imported. terminal or bulk plant and transported by you within the state of Indiana from Schedule 3A - Instate Transfers. Line 4 Enter the total gallons of fuel transported. (Add lines 1, 2, and 3.) Reminder! Be sure to sign and date your return. Failure to do so may result in penalties for filing an incomplete return. American LegalNet, Inc. www.FormsWorkflow.com