Form 6627

(Rev. January 2024) 

Department of the Treasury 

Internal Revenue Service 

Environmental Taxes 

Attach to Form 720.

Go to www.irs.gov/Form6627 for instructions and the latest information.

OMB No. 1545-0023

Name (as shown on Form 720) Quarter ending Employer identification number (EIN) 

Part I Tax on Petroleum (a) 

Barrels

(b) 

Rate

(c) 

Tax

1 Crude oil received at a U.S. refinery . . . . . . . . . . . .

2 Crude oil taxed before receipt at refinery . . . . . . . . . .

3 Taxable crude oil. Subtract line 2 from line 1. Enter the result on both 

lines 3(a) and 3(b), column (a). Enter in column (c) the amount of tax by 

multiplying column (a) by column (b) for both lines. (a) $ .17 bbl $

(b) $ .09 bbl $

4 Crude oil used in the U.S. before the tax was imposed. Multiply column 

(a) by column (b) and enter the amount of tax in column (c). Enter on both 

lines 4(a) and 4(b), column (a). Enter in column (c) the amount of tax by 

multiplying column (a) by column (b) for both lines. (a) $ .17 bbl $

(b) $ .09 bbl $

5 Total domestic petroleum superfund tax (add lines 3(a) and 4(a), column 

(c)). Enter here and on Form 720 on the line for IRS No. 53 . . . . $

6 Total domestic petroleum oil spill tax. Add lines 3(b) and 4(b), column (c). 

Enter the total here and on Form 720 on the line for IRS No. 18 . . . $

7 Imported petroleum products superfund tax. Enter the number of barrels 

imported in column (a). (Must agree with line 8, column (a).) Enter in 

column (c) the amount of tax by multiplying column (a) by column (b), and 

also enter it on Form 720 on the line for IRS No. 16 . . . . . . . $ .17 bbl $

8 Imported petroleum products oil spill tax. Enter the number of barrels 

imported in column (a). (Must agree with line 7, column (a).) Multiply 

column (a) by column (b) and enter the amount of tax in column (c). Also 

enter the amount on Form 720 on the line for IRS No. 21 . . . . . $ .09 bbl $

Part II Tax on Chemicals (Other Than Ozone-Depleting Chemicals (ODCs)), IRS No. 54

Chemical 

(general formula 

or symbol)

(a) Tons (b) Rate

(c) Tax 

(multiply column (a) 

by column (b))

1 Acetylene (C2H2) $9.74

2 Ammonia (NH3) . 5.28

3 Antimony (Sb) . 8.90

4 Antimony trioxide 

(Sb2O3) . . . 7.50

5 Arsenic (As) . . 8.90

6 Arsenic trioxide 

(As2O3) . . . . 6.82

7 Barium sulfide (BaS) 4.60

8 Benzene (C6H6) . 9.74

9 Bromine (Br) . . 8.90

10 Butadiene (C4H6) 9.74

11 Butane (C4H10) . 9.74

12 Butylene (C4H8) . 9.74

13 Cadmium (Cd) . 8.90

14 Chlorine (Cl) . . 5.40

15 Chromite (FeCr2O4) 3.04

16 Chromium (Cr) . 8.90

17 Cobalt (Co) . . 8.90

18 Cupric oxide (CuO) 7.18

19 Cupric sulfate (CuSO4) 3.74

20 Cuprous oxide (Cu2O) 7.94

21 Ethylene (C2H4) . 9.74

22 Hydrochloric acid (HCI) 0.58

23 Hydrogen fluoride (HF) 8.46

Chemical 

(general formula 

or symbol)

(a) Tons (b) Rate

(c) Tax 

(multiply column (a) 

by column (b))

24 Lead oxide (PbO) $8.28

25 Mercury (Hg) . . 8.90

26 Methane (CH4) . 6.88

27 Naphthalene (C10H8) 9.74

28 Nickel (Ni) . . . 8.90

29 Nitric acid (HNO3) 0.48

30 Phosphorus (P) . 8.90

31 Potassium 

dichromate (K2Cr2O7) 3.38

32 Potassium 

hydroxide (KOH) . 0.44

33 Propylene (C3H6) . 9.74

34 Sodium dichromate 

(NaCr2O7) . . . 3.74

35 Sodium hydroxide 

(NaOH) . . . . 0.56

36 Stannic chloride 

(SnCl4) . . . . 4.24

37 Stannous chloride 

(SnCl2) . . . . 5.70

38 Sulfuric acid (H2SO4) 0.52

39 Toluene (C7H8) . 9.74

40 Xylene (C8H10) . 9.74

41 Zinc chloride (ZnCl2) 4.44

42 Zinc sulfate (ZnSO4) 3.80

43 Total Chemical Tax (add lines 1–42, column (c)). Enter here and on Form 720 on the line for IRS No. 54 $

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 720. Cat. No. 43490I Form 6627 (Rev. 1-2024) 
Form 6627 (Rev. 1-2024) Page 2

Part III Tax on Imported Chemical Substances, IRS No. 17

(a) Imported chemical 

substance (b) Tons 

(c) Taxable chemical 

used in manufacture 

of substance 

(d) Conversion factor or 

entry value (e) Rate (f) Tax (see instructions) 

1

2

3

4 Total imported chemical substances tax. Add all amounts in column (f). Include amounts from any

additional sheets. Enter here and on Form 720 on the line for IRS No. 17 . . . . . . . . . . $ 

Part IV Tax on Ozone-Depleting Chemicals (ODCs), IRS No. 98 

Elections. If you elect to report the tax on post-1989 ODCs at the time you sell or use a mixture containing such chemicals 

instead of when you make the mixture, check this box (the 1990 election) . . . . . . . . . . . . . . . . . .

If you elect to report the tax on post-1990 ODCs at the time you sell or use a mixture containing such chemicals instead of when 

you make the mixture, check this box (the 1991 election) . . . . . . . . . . . . . . . . . . . . . . .

(a) ODC (b) Number 

of pounds 

(c) Tax per pound 

(see Part IV instructions) 

(d) Tax 

(multiply column (b) 

by column (c)) 

1

2

3

4 Total ozone-depleting chemicals tax. Add all amounts in column (d). Include amounts from any

additional sheets. Enter the total here and on Form 720 on the line for IRS No. 98 . . . . . . . $ 

Part V ODC Tax on Imported Products, IRS No. 19 

Election. If you elect to report the tax on imported products at the time you import the products instead of when you sell or use 

the products, check this box . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(a) Imported product and 

the applicable ODC 

(b) Number 

of products 

(c) ODC weight 

of product 

(d) Tax 

per pound (e) Entry value (f) Tax (see Part V instructions)

1

2

3

4 Total ODC tax on imported products. Add all amounts in column (f). Include amounts from any

additional sheets. Enter the total here and on Form 720 on the line for IRS No. 19 . . . . . . . $ 

Part VI Tax on Floor Stocks of ODCs, IRS No. 20 

(a) ODC (b) Number 

of pounds 

(c) Tax per pound 

(see Part VI instructions) 

(d) Tax 

(multiply column (b) 

by column (c)) 

1

2

3

4 Total floor stocks tax. Add all amounts in column (d). Include amounts from any additional sheets. 

Enter the total here and on Form 720 on the line for IRS No. 20 . . . . . . . . . . . . . $ 

Form 6627 (Rev. 1-2024)