OMB No. 1545-0162 Credit for Federal Tax Paid on Fuels

Form 4136 (And Credit for Purchase of Diesel-Powered Highway Vehicles)

Department of the Treasury

Internal Revenue Service

Attachment

© Attach this form to your income tax return. Sequence No. 23

Name (as shown on your income tax return) Taxpayer identification number

Diesel-Powered Highway Vehicle Credit

(a)

Number of

vehicles

(c)

Credit

(col. (a) 3 col. (b))

(b)

Credit per vehicle

1 Diesel-powered cars $102.00 $

2 Diesel-powered light trucks and vans 198.00

3 Total diesel-powered highway vehicle credit. Add lines 1 and 2, column (c) © $

Fuel Tax Credit Caution: You cannot claim any amounts on Form 4136 that you claimed on

Form 8849, Form 843, or Schedule C (Form 720).

Cat. No. 12625R Form 4136 (1995)

Part I

Part II

1

2

3 318

5 Nontaxable Use of Gasohol (See instructions.)

Rate Gallons Amount of credit CRN

312

Gasohol containing at least 10% alcohol

Gasohol containing at least 7.7% alcohol but less than

10% alcohol

Gasohol containing at least 5.7% alcohol but less than

7.7% alcohol

$.13

.1424

.1532

Nontaxable Use of Gasoline (See instructions.)

Rate Gallons Amount of credit

Off-highway business use $.184

4

CRN

301

Nontaxable Use of Undyed Diesel Fuel (Lines 6a, b, and c)

Sales by Registered Ultimate Vendors of Undyed Diesel Fuel (Line 6d) (See instructions.)

Rate Gallons Amount of credit

$.244

6

CRN

303

CRN

Use on a farm for farming purposes .184

.184

b

a

c

Heating oil

b Off-highway business use

a

c

.244

.244

.244

d

a

b

c

(99)

Claimant sold undyed diesel fuel (a) to a state or local

government for its exclusive use or (b) for use by the

buyer on a farm for farming purposes. Claimant is a

registered ultimate vendor, sold the fuel at a tax-excluded

price, certifies that the diesel fuel did not contain visible

evidence of dye, and obtained the required certificate

from the buyer and has no reason to believe any of the

information in the certificate is false.

Other

Other nontaxable use

%

%

%

Lines 6a, b, and c: Purchaser bought undyed diesel fuel,

certifies that the diesel fuel did not contain visible

evidence of dye, and used that diesel fuel for a

nontaxable use. Caution: No claim is allowed on lines 6a,

b, or c for use on a farm for farming purposes or for use

by a state or local government.

© See the Instructions for Form 4136.

Type

of use

Type

of use

Type

of use
12 Total fuel tax credit. Add lines 4–11 © $

Total Income Tax Credit

Total income tax credit claimed (add lines 3 and 12). Enter here and on Form 1040, line

60 (also check box b on line 60); Form 1120, line 32g; Form 1120-A, line 28g; Form

1120S, line 23c; Form 1041, line 24g; or the proper line of other returns © $

Form 4136 (1995) Page 2

Part III

12

13

13

Gasohol Blenders (Caution: Do not claim for any gasohol sold or used after September 30, 1995. See instructions on page 4.)

Claimant bought gasoline taxed at the full rate ($.184)

and blended it with alcohol to make gasohol. The gasohol

was used or sold for use in a trade or business.

Percentage of alcohol in the gasohol Rate Gallons of gasoline Amount of credit CRN

At least 10% alcohol

At least 7.7% alcohol but less than 10% alcohol

At least 5.7% alcohol but less than 7.7% alcohol

$.0396

.0298

.0216

10

302

Use of Undyed Diesel Fuel—Train and Intercity and Local Bus (See instructions.)

Claimant bought undyed diesel fuel, certifies that the

diesel fuel did not contain visible evidence of dye, and

used the diesel fuel in an engine that propels a

diesel-powered train or an automobile bus.

CRN

Diesel-powered trains

11

Rate Gallons

Certain intercity and local buses

$.175/

.17

305

Amount of credit

b

a

c

a

b

8

Special motor fuel (other than LPG)

9

Nontaxable Use of Gasoline Used in Aviation (See instructions.)

Nontaxable Use of Aviation Fuel (other than gasoline)

$.184

Used in foreign trade, on a farm, or in certain

helicopters

Used in commercial aviation (other than foreign trade)

Used in foreign trade, on a farm, or in certain

helicopters

Used in commercial aviation (other than foreign trade)

$.219

.218/

.175*

$.184

.183/

.14*

7

Compressed natural gas (credit rate per thousand

cubic feet) .4854

Rate Gallons Amount of credit CRN

Rate Gallons Amount of credit CRN

Rate Gallons Amount of credit CRN

304

307

310

Nontaxable Use of Special Fuels

a

b

a

b

a

b

Liquified petroleum gas (LPG)

LPG used in intercity or local buses

.183

c .109

d

%

%

%

%

%

* This rate is only for fuel purchased and used after September 30, 1995. However, pending legislation may change the rates for lines 8b and 9b. Get Pub. 553,

Highlights of 1995 Tax Changes.

MCF

.1875*

Type

of use

Type

of use

Type

of use
Form 4136 (1995) Page 3

Requirements.—To claim a fuel tax credit you must (1) buy

taxed fuel, and (2) use it for a purpose listed in the Type of

Use Table (see below).

Reporting fuel tax credit in income.—You must include the

amount of the credit from line 12, Part II, in your gross

income if you took a deduction on your tax return for the

taxes paid and that deduction reduced your tax liability.

General Instructions

Purpose of form.—Use Form 4136 to claim the credit for

diesel-powered highway vehicles and to claim the credit for

Federal excise tax paid on fuels. (Partnerships cannot file this

form; instead, they must include a statement on Schedule

K-1 (Form 1065), Partner’s Share of Income, Credits,

Deductions, etc., showing the allocation of the credits to

each partner specifying the number of gallons of fuel

allocated to each partner and the applicable tax rates.)

Part II—Fuel Tax Credit

Specific Instructions

Part I—Diesel-Powered Highway Vehicle

Credit

If you bought a diesel-powered highway vehicle during the

year for a use other than resale and you are the first

purchaser, you may claim a one-time credit of $102 for an

Additional information.—You can file Form 8849, Claim for

Refund of Excise Taxes, to claim a refund of excise taxes

instead of claiming credit on Form 4136. Pub. 378, Fuel Tax

Credits and Refunds, includes definitions and additional

excise tax rules. Pub. 225, Farmer’s Tax Guide, and Pub.

510, Excise Taxes for 1996, also include information on the

credit for Federal tax paid on fuels.

Type of Use Table

The table below lists the most common uses for which you

may claim a credit for taxes paid on fuels. You must enter

the item number from the table in the applicable boxes in the

Type of Use column. See Pub. 378 for definitions of these

uses.

Line 4

4a. Off-highway business use.—You must have used the

gasoline for a business use other than in a highway vehicle

registered (or required to be registered) for highway use. You

cannot claim a credit for personal use of gasoline.

4b. Use on a farm for farming purposes.—You must have

used the gasoline on a farm for farming purposes. You

cannot claim a credit for personal use of gasoline.

4c. Other nontaxable uses of gasoline.—You may claim a

credit for gasoline used for uses 3, 4, 6, 8, and 10 from the

Type of Use Table. List the item number for the type of use

on line 4c. To claim a credit for gasoline used in aviation, see

line 8.

Recordkeeping.—You must keep records to support any

credits claimed on this return for at least 3 years from the

date the return is due or filed, whichever is later.

Changes to note.—The rates shown on Form 4136 for lines

8b, 9b, and 11a have changed. The second rate (*) is

effective for claims for fuel purchased and used after

September 30, 1995.

Also, the refund provisions for gasohol blenders have

expired for gasohol sold or used after September 30, 1995.

See the line 10 instructions on page 4.

Line 5

You may claim a credit for the tax included in the price of

gasohol used for uses 1, 2, 3, 4, 6, 8, and 10 from the Type

of Use Table. The credit rate per gallon is based on the

percentage of alcohol in the mixture. To claim a credit for

gasoline blended to make gasohol, see line 10.

Paperwork Reduction Act Notice.—We ask for the

information on this form to carry out the Internal Revenue

laws of the United States. You are required to give us the

information. We need it to ensure that you are complying

with these laws and to allow us to figure and collect the right

amount of tax.

The time needed to complete and file this form will vary

depending on individual circumstances. The estimated

average time is:

If you have comments concerning the accuracy of these

time estimates or suggestions for making this form simpler,

we would be happy to hear from you. You can write to the

Internal Revenue Service at the address listed in the

instructions of the tax return with which this form is filed.

Instructions for Form 4136

You must enter an item number from the Type of Use

Table (see below) on lines 5, 7, 8a, and 9a, as well as on

lines 4c and 6c.

Recordkeeping 12 hr., 59 min.

Preparing and sending

the form to the IRS 13 min.

four wheels, has a gross vehicle weight rating of 10,000

pounds or less, and is registered under the laws of any state

for highway use in the United States. If you claim the credit

for diesel-powered vehicles, you must reduce the depreciable

basis of the vehicle by the credit claimed.

Item No. Type of Use

1 On a farm for farming purposes

2 For business other than in a highway vehicle registered

(or required to be registered) for highway use

3 Export

4 In a boat used in the business of commercial fishing

5 For diesel fuel in a boat in

● the business of transporting persons or property for

compensation or hire, or

● any other trade or business, except an activity

generally considered entertainment, amusement, or

recreation

6 In an intercity or local bus

7 For diesel fuel in a qualified local bus that

● can seat at least 20 adults (excluding the driver) and

● is under contract by a state or local government to

furnish (for compensation) intracity passenger land

transportation that is available to the general public and

is scheduled and along regular routes

8 In a bus that transports students and school employees

9 For diesel fuel other than as a fuel in the propulsion

engine of a diesel-powered highway vehicle, train, or

boat, including use as home heating oil

10 In foreign trade

11 In commercial aviation

12 In certain helicopters

Type of Use Table (See instructions above.)

automobile and $198 for a light truck or van. The vehicle

must be a diesel-powered highway vehicle that has at least
Form 4136 (1995) Page 4

9b. Used in commercial aviation (other than foreign

trade).—If you bought aviation fuel taxed at the full rate, you

may claim a credit for the tax included in the price of aviation

fuel used for domestic commercial aviation.

7a, b, and c. Special motor fuel.—Special motor fuel

generally may be bought for nontaxable purposes at a price

that does not include the excise tax. However, if you bought

taxed special motor fuel, you may claim a credit for the tax

included in the price of special motor fuel used for uses 1, 2,

3, 4, 6, 8, and 10 from the Type of Use Table. Use the credit

rate shown on lines 7a through 7c for the above uses.

Line 10

Line 8

Line 9

9a. Used in foreign trade, on a farm, or in certain

helicopters.—Aviation fuel generally may be bought for

nontaxable purposes at a price that does not include the

excise tax. However, if you bought taxed aviation fuel, you

may claim a credit for the tax included in the price of aviation

fuel used for uses 1, 10, and 12 from the Type of Use Table.

8a. Used in foreign trade, on a farm, or in certain

helicopters.—You may claim a credit for the tax included in

the price of gasoline used in aviation for uses 1, 10, and 12

from the Type of Use Table. If you bought gasoline for use in

aviation at a rate other than 18.4 cents a gallon, attach an

explanation of the amount of credit you are claiming.

8b. Used in commercial aviation.—You may claim a credit

for the tax included in the price of gasoline used in domestic

commercial aviation.

7d. Compressed natural gas.—Compressed natural gas

generally may be bought for nontaxable purposes at a price

that does not include the excise tax. However, if you bought

compressed natural gas at a price that included the tax, you

may claim a credit for the tax included in the price of

compressed natural gas used for uses 1, 2, 3, 4, 6, 8, and 10

from the Type of Use Table. The rate shown on line 7d is

per thousand cubic feet (MCF).

Printed on recycled paper

You must attach the following information for each batch

of gasohol:

1. The name, address, and employer identification number

of the supplier(s) of the gasoline and alcohol,

2. The dates of purchase of the gasoline and alcohol,

3. The number of gallons of gasoline and alcohol

purchased, and

4. The number of gallons and the type of gasohol

produced.

Line 11

You must have used the undyed diesel fuel for train or

certain intercity or local bus use. For bus uses that qualify for

a full refund of the tax, see line 6.

6d. Sales by registered ultimate vendors.—You must

attach the following information:

If you bought gasoline taxed at the full rate, have not

claimed a refund, and used that gasoline to make gasohol,

you may claim a credit for each gallon of gasoline used to

make gasohol. The credit rate per gallon is based on the

percentage of alcohol in the mixture.

Line 7

3. The name, address, telephone number, and TIN of each

farmer, custom harvester, or governmental unit who bought

undyed diesel fuel and the number of gallons that the

claimant sold to each.

1. A copy of the claimant’s registration letter;

2. The name, address, telephone number, and employer

identification number (EIN) of each person who sold diesel

fuel to the claimant and the date of purchase; and

1. The name, address, telephone number, and TIN of the

person(s) who sold diesel fuel to the claimant and the dates

of purchase; and

2. The seller’s statement that the diesel fuel did not

contain visible evidence of dye.

You must attach the following information:

You must attach the following information for lines 6a

through 6c:

1. The name, address, telephone number, and taxpayer

identification number (TIN) of the person(s) who sold diesel

fuel to the claimant and the dates of purchase;

2. A copy of the seller’s statement that the diesel fuel did

not contain visible evidence of dye; and

3. A statement that the claimant has proof of exportation if

the fuel was exported.

Caution: You cannot include on line 10 any claim for gasohol

sold or used after September 30, 1995.

6c. Other nontaxable use of undyed diesel fuel.—You may

claim a credit for undyed diesel fuel used for uses 3, 4, 5, 7,

8, and 9 from the Type of Use Table. List the item number

from the type of use table on line 6c. To claim a credit for

undyed diesel fuel used in certain intercity or local buses or

diesel-powered trains, see line 11.

6a. Heating oil.—You may claim a credit for undyed diesel

fuel that is used as heating oil.

6b. Off-highway business use of undyed diesel fuel.—You

must have used the diesel fuel for a business use other than

in a highway vehicle registered (or required to be registered)

for highway use.

Line 6

Note: You cannot claim a credit for any use of dyed diesel

fuel.