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

Form 4136

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

Cat. No. 12625R Form 4136 (2006)

2 Nontaxable Use of Aviation Gasoline

Nontaxable Use of Gasoline

(b) Rate (c) Gallons (d) Amount of credit

Off-highway business use

1

(e) CRN

362

3 Nontaxable Use of Undyed Diesel Fuel

Use on a farm for farming purposes

a

b

c Other nontaxable use (see Caution above line 1)

© See the separate instructions.

(a) Type of use

For Paperwork Reduction Act Notice, see the separate instructions.

Use in commercial aviation (other than foreign trade) 354

Other nontaxable use (see Caution above line 1)

a

b

Nontaxable use

Use in certain intercity and local buses (see Caution

above line 1)

a

b

d

Use in trains

360

350

$

4

$

$

% $ .183

.183

.183

$ .15

.193

$ .243

.243

.17

324

Nontaxable Use of Undyed Kerosene (Other Than Kerosene Used in Aviation)

Claimant certifies that the kerosene did not contain visible evidence of dye.

Exception. If any of the kerosene included in this claim did contain visible evidence of dye, attach an explanation and check here ©

Nontaxable use $ .243 $

Caution. Claimant has the name and address of the person who sold the fuel to the claimant and the dates of purchase. 

For claims on lines 1c and 2b (type of use 13 and 14), 3d, 4c, 5, and 9, claimant has not waived the right to

make the claim. For claims on lines 1c and 2b (type of use 13 and 14), claimant certifies that a certificate has

not been provided to the credit card issuer.

2006

Kerosene Used in Commercial Aviation (Other Than Foreign Trade)

Kerosene taxed at $.244 (see Caution above line 1)

Kerosene taxed at $.219 (see Caution above line 1)

a

b

$ .200

.175

5

417

c

(a) Type of use (b) Rate (c) Gallons (d) Amount of credit (e) CRN

(a) Type of use (b) Rate (c) Gallons (d) Amount of credit (e) CRN

(a) Type of use (b) Rate (c) Gallons (d) Amount of credit (e) CRN

a

c Use in certain intercity and local buses (see Caution

above line 1) .17 347

(b) Rate (c) Gallons (d) Amount of credit (e) CRN

$

Use on a farm for farming purposes

Use on a farm for farming purposes

e .244 413

b .243 346

d Exported .184 411

c Exported .194 412

Exported

.22

d Exported .244 414

353

%

%

355

Claimant certifies that the diesel fuel did not contain visible evidence of dye.

Exception. If any of the diesel fuel included in this claim did contain visible evidence of dye, attach an explanation and check here ©
Form 4136 (2006) Page 2

Sales by Registered Ultimate Vendors of Undyed Kerosene (Other

Than Kerosene For Use in Aviation)

7

Exception. If any of the kerosene included in this claim did contain visible evidence of dye, attach an explanation and check here ©

Claimant certifies that it sold the kerosene at a tax-excluded price, repaid the amount of tax to the buyer, or has obtained the written consent

of the buyer to make the claim. Claimant certifies that the kerosene did not contain visible evidence of dye.

a

b Sales from a blocked pump

c

Registration No. ©

Form 4136 (2006)

8 Sales by Registered Ultimate Vendors of Kerosene For Use in Aviation

Use in commercial aviation (other than foreign trade)

taxed at $.244

a

b

Claimant sold the kerosene for use in aviation at a tax-excluded price and has not collected the amount of tax from the buyer, repaid 

the amount of tax to the buyer, or has obtained the written consent of the buyer to make the claim. See the instructions for additional 

information to be submitted.

Registration No. ©

(b) Rate (c) Gallons (d) Amount of credit (e) CRN

346 $ .243 $

.243

(b) Rate (c) Gallons (d) Amount of credit (e) CRN

355

(a) Type of use

$ $ .175

.200

346

c Nonexempt use in noncommercial aviation .025

d Other nontaxable uses taxed at $.244 .243

Use in certain intercity and local buses .17 347

Use by a state or local government

e Other nontaxable uses taxed at $.219 .218

Use in commercial aviation (other than foreign trade)

taxed at $.219

417

418

369

%

6 Sales by Registered Ultimate Vendors of Undyed Diesel Fuel

Exception. If any of the diesel fuel included in this claim did contain visible evidence of dye, attach an explanation and check here ©

Claimant certifies that it sold the diesel fuel at a tax-excluded price, repaid the amount of tax to the buyer, or has obtained the written 

consent of the buyer to make the claim. Claimant certifies that the diesel fuel did not contain visible evidence of dye.

Registration No. ©

a Use by a state or local government 360

b

$ .243 $

Use in certain intercity and local buses .17

(b) Rate (c) Gallons (d) Amount of credit (e) CRN

350

Nontaxable Use of Kerosene Used in Noncommercial Aviation

Reserved for future use

9

10

Nontaxable use (other than state) taxed at $.219 (see

Caution above line 1)

a

b

(b) Rate (c) Gallons (d) Amount of credit (e) CRN

346

(a) Type of use

$ $ .243

.218

Nontaxable use (other than state) taxed at $.244 (see

Caution above line 1)

369
Liquefied petroleum gas (LPG)

Form 4136 (2006) Page 3

Nontaxable Use of Alternative Fuel (after September 30, 2006)

“P Series” fuels

a

b

Form 4136 (2006)

c Compressed natural gas (CNG) (GGE = 126.67 cu. ft.)

14

(b) Rate (d) Amount of credit (e) CRN

$ .183 $ 419

.183

.183

15 Alternative Fuel Credit and Alternative Fuel Mixture Credit (after

September 30, 2006)

Liquefied petroleum gas (LPG)

“P Series” fuels

a

b

426

427

Registration No. ©

(b) Rate (c) Gallons

or gasoline 

gallon

equivalents (GGE)

(d) Amount of credit (e) CRN

$ .50

.50

$

Compressed natural gas (CNG) (GGE = 121 cu. ft.)

Liquefied hydrogen

c

d

Any liquid fuel derived from coal (including peat) through the

Fischer-Tropsch process

Liquid hydrocarbons derived from biomass

e

f

g Liquefied natural gas (LNG)

.50

.50

.50

.50

.50

428

429

430

431

432

Liquefied hydrogen

Any liquid fuel derived from coal (including peat) through

the Fischer-Tropsch process

d

e

f Liquid hydrocarbons derived from biomass

g Liquefied natural gas (LNG)

.183

.243

.243

.243

420

421

422

423

424

425

(c) Gallons

or gasoline 

gallon

equivalents (GGE)

Biodiesel (other than agri-biodiesel) mixtures 388

Agri-biodiesel mixtures

a

b 390

(b) Rate (c) Gallons of 

biodiesel or 

renewable

diesel

(d) Amount of credit (e) CRN

$ .50

1.00

$

c Renewable diesel mixtures 1.00 307

Use in certain intercity and local buses

Nontaxable Use of Liquefied Petroleum Gas (LPG) (before October 1, 2006)

Use in qualified local buses or school buses

a

b

c Other nontaxable use

12 Alcohol Fuel Mixture Credit

Alcohol fuel mixtures containing ethanol

Alcohol fuel mixtures containing alcohol (other than ethanol)

a

b

Claimant produced an alcohol fuel mixture by mixing taxable fuel with alcohol. The alcohol fuel mixture was sold by the claimant to any

person for use as a fuel or was used as a fuel by the claimant.

Registration No. ©

11

(b) Rate (c) Gallons (d) Amount of credit (e) CRN

352

(a) Type of use

$ .062 $

.136 361

.136 395

(b) Rate (c) Gallons of

alcohol

(d) Amount of credit (e) CRN

$ .51

.60

$ 393

394

13 Biodiesel or Renewable Diesel Mixture Credit

Claimant produced a mixture by mixing diesel fuel with biodiesel or renewable diesel. The biodiesel used to produce the biodiesel mixture

must meet ASTM D6751 and be registered with the EPA as a fuel and fuel additive under section 211 of the Clean Air Act. The mixture was 

sold by the claimant to any person for use as fuel or was used as a fuel by the claimant. Claimant has a certificate from the producer or

importer of the biodiesel which identifies the percentage of biodiesel and agri-biodiesel in the product, and has no reason to believe the

information is false. See the instructions for line 13 to see if you must attach the certificate.

Registration No. ©

Caution. There is a reduced credit rate for use in certain intercity and local buses (type of use 5). See page 4 in the Instructions for Form 4136 for the credit rate.

(a) Type of use
Form 4136 (2006) Page 4

Form 4136 (2006)

19 Exported Dyed Fuels

Exported dyed diesel fuel

Exported dyed kerosene

a

b

16 Registered Credit Card Issuers

Diesel fuel sold for the exclusive use of a state or local government

Kerosene sold for the exclusive use of a state or local government

a

b

(b) Rate (c) Gallons (d) Amount of credit (e) CRN

$ .243 360

Registration No. ©

$

(b) Rate (c) Gallons (d) Amount of credit (e) CRN

$ .001

.001

$ 415

416

20 $

20 Total income tax credit claimed. Add lines 1 through 19, column (d). Enter here and on

Form 1040, line 70 (also check box b on line 70); Form 1120, line 32f(2); Form 1120-A, line 

28f(2); Form 1120S, line 23c; Form 1041, line 24h; or the proper line of other returns. ©

Kerosene for use in aviation sold for the exclusive use of a state or local

government

c

346

369

.243

.218

Nontaxable use

Nontaxable Use of a Diesel-Water Fuel Emulsion

Exported

a

b

17

(b) Rate (c) Gallons (d) Amount of credit (e) CRN

309

(a) Type of use

$ .197 $

.198 306

Blender credit

18 Diesel-Water Fuel Emulsion Blending

(b) Rate (c) Gallons (d) Amount of credit (e) CRN

$ .046 $ 310

Registration No. ©

Caution. There is a reduced credit rate for use in certain intercity and local buses (type of use 5). See page 4 in the Instructions for Form 4136 for the credit rate.