Aviation fuel.—A tax is imposed on aviation fuel
sold for use or used in noncommercial aviation.
The retailers tax on aviation gasoline is in addition
to the manufacturers tax. If fuel was taxed on its
sale as a special motor fuel but subsequently it is
used as aviation fuel, the tax on the user would be
the difference between the 14¢ rate and the rate
previously paid on the sale of the fuel to the user.

Inland Waterway Fuel

In addition to the tax on special motor fuel used
in a motorboat, there is a 6¢-a-gallon excise tax
imposed on the use of any liquid used as a fue! in
vessels for commercial transportation on the inland
waterways. See Publication 510 for more informa-
tion.

Special Provisions for Petroleum Products

Use in certain buses.—Amounts equal to the
taxes on motor fuels and lubricating oil may be
repaid to the ultimate purchaser if used in certain
intercity, local or school buses. See Form 4136,

Gasohol.—The sale of gasoline or other motor
fuel for use in manufacturing gasohol is exempt
from the 4¢ per gallon excise tax. To qualify, the
gasohol must contain at least 10% alcohol that is
at least 190 proof.

If you plan to make gasohol, using specially de-
natured alcohol, you must first get a permit from
the Alcohol, Tobacco, and Firearms Bureau.

Anyone who separates the gasoline or motor fuel
from the mixture, which has been sold tax-free, will
be subjected tothe excise tax on_the separated
fuels. This tax is reported on Form 720 on the line
for IRS No. 61 or 62.

Rerefined lubricating oi —The tax does not ap-
ply when—

© Lubricating oif is sold to a rerefiner to be
mixed with used or waste lubricating oil that has
been cleaned, renovated, or rerefined, and

© The blend contains at least 25% used oil and
55% or less new oi

Crude Oil Windfall Profit Tax

The tax on windfall profit is computed on Form
6047, Windfall Profit Tax, which must be attached
to Form 720 on a quarterly basis by the purchasers,
qualified disbursers, operators, and certain pro-

lucers.

Producers will receive Form 6248, Annual Infor-
mation Return of Windfall Profit Tax, from their
purchasers at the end of each year. The form shows
total tax liability, tax paid by purchaser, and the
amount of any tax underwithheld or overwithheld.

If the tax was underwithheld, the producer must
file Form 720 to report and pay the balance due
on the first quarter return, by May 31. This amount
should be entered in the space marked “Annual
return” on the line for IRS No. 52 and the social
security number of the producer should be entered
in the space to the right of IRS No. 52. If tax was
overwithheld, see Form 6249, Computation of Over-
Paid Windfall Profit Tax.

Environmental Taxes

The tax rates for the environmental taxes are
shown on Form 6627, Environmental Taxes. Form
6627 is used to compute the liability for these
taxes and must be attached to Form 720 each
quarter.

Line 2, Adjustments.—Generally, you may make
adjustments for taxes reported on Form 720 (1) to
correct mathematical errors, or (2) to adjust pay-

ments of tax on transactions, charges, or processing
that are entitled to be made tax-free.

On line 2, enter the total of any adjustments
claimed. Attach a statement that includes the fol-
lowing:

(a) An explanation of why you are claiming a re-

duction in tax.

(b) A statement that you have the required sup-

porting evidence.

(c) The IRS Numbers being adjusted.

(d) The amount of adjustment claimed for each.

(e) The period in which the tax liability was pre-

viously reported.

Line 4, Record of Federal Tax_Liability.—You
must deposit all excise taxes over $100 reportable
on Form 72C at an authorized depositary or the
Federal Reserve Bank (FRB) serving the area in
which you are located. Follow the instructions on
the back of Federal Tax Deposit (FTD) Form 504
Send a Form 504 with each deposit. The deposit
must be in a form of payment that the FRB con-
siders to be an immediate credit item. You can get
more information from a depositary or FRB.

The following rules explain how often you must
make deposits for excise taxes other than windfall
profit taxes or inland waterway taxes. (For special
rules on depositing windfall profit taxes, see the
instructions for Form 6047.) No deposits are re-
quired for the inland waterway tax. The tax is pay-
able with the return.

In general, the frequency of deposits is based on
the amount of tax you owe for a certain period. You
must make deposits monthly or semimonthly, as
explained below.

Monthly deposits.—You must make monthly de-
posits if—You are liable in any month (except the
last month of the quarter) for more than $100 of
taxes reportable on Form 720, AND you are not
required to make semimonthly deposits (see
below).

Monthly deposits are due by the last day of the
month following the month you incur the $100
liability.

If you owe taxes of $100 or less at the end of
the first or second month, carry them over to the
next month. At the end of the third month, taxes of
$100 or less may be deposited or paid’ with the
return.

If you owe taxes of more than $100 at the end
of the third month, you must deposit them by the
last day of the following month.

For air transportation and communications taxes,
the tax that is computed on the basis of amounts
billed (communications) or tickets sold (air trans-
portation) for a month is considered collected dur-
ing the next month and should be reported during
the month following the month it is considered col-
lected.

Semimonthly deposits—If you are liable for
over $2,000 of excise tax for any month of a
quarter, you must make semimonthly deposits of
taxes in the following quarter. (A ‘'semimonthly”"
period means the first 15 days of a month or the
16th through the last day of a month.)

The rules for making semimonthly deposits are
as follows:

(A) In general: Deposit the amount you owe by
the 9th day following the semimonthly period for
which it is reported.

(B) Air transportation and communications
taxes: If the amount for these taxes is computed
on the basis of amount billed (communications) or
tickets sold (air transportation), the tax computed
for a semimonthly period is considered as collected
during the second following semimonthly period.
Deposit these taxes within 3 banking days after the
end of the semimonthly period for which it is con-
sidered collected.

If the tax is computed on any other basis, deposit
the taxes within 3 banking days after the end of the
semimonthly period in which it was collected. In
determining banking days, do not count local bank-
ing holidays observed by depositaries or Saturdays,
Sundays, and legal holidays.

(C) Policies issued by foreign insurers: If the
amount of tax on these policies is for the first semi-
monthly period, deposit it by the Ist day of the
next month. If the amount is for the second semi-
monthly period, deposit it by the 15th day of the
next month.

Exceptions.—You are considered to meet the
semimonthly deposit requirements if the amount
you deposit for the semimonthly period is one of
the following:

(1) at least 90% of the total tax collected during
(or reportable for) the semimonthly period.

(2) At least 45% of the total tax collected during
(or reportable for) the month.

(3) At least 50% of the total tax collected during
(or reportable for) the second preceding month
(first. preceding month for air transportation and
communications).

(4) Manufacturers and retailers taxes: An
amount deposited for the second semimonthly pe-
riod in a month that, when added to the deposit
for the first semimonthly period, is at least 90%
of the total taxes reportable for the month.

In addition, if the semimonthly period is in either
of the first 2’ months of the quarter, you must de-
posit the underpayment for the month by the fol-
lowing dates:

(a) Tax on foreign insurances policies—The first
day of the second month following the month in-
volved.

(b) Manufacturers and retailers taxes—The ninth
day of the second month following the month in-
volved

(c) Air transportation and communications—The
last day of the month following the month involved.

Notes:

(1) If you meet the semimonthly deposit under
(2), (3), or (4) above, you may be exempt from
certain recordkeeping requirements. You may not
have to—

(a) Keep books and records on a semimonthly

basis (except for deposits), or

(b) Record your tax liability on a semimonthly

basis in line 4. See regulations sections
48.6302(c)-1 and 49.6302(c)-1.

(2) You do not meet the requirements under (2)
or (3) above if you collect more than 75% of air
transportation or communications taxes (or incur
more than 75% of the monthly liability for other
taxes) in the first semimonthly period in each
month.

Notes on making deposits:

1. If you are paying a tax for the first time or
you need more forms, contact the District Director
or the Director of the Service Center for your area
in time to make the required deposits. (See “Where
to File"’.) Send any tax due and not deposited along
with the return. For more information, see Publica-
tion 583.

2. The above provisions do not extend the time
for depositing taxes for the last semimonthly pe-
riod of the quarter. Nor do they remove penalties
for failure to make other required deposits on time.

Lines 5 and 8, Overpayment—lIf you deposited
more than the amount you owed for a quarter, you
may have the overpayment applied to your next
return or refunded to you. Enter the appropriate
amount in the space on line 8. Enter on line 5 of
your next return any amount you want to have
applied to your next return,



rom 120

(Rev. Oct. 1982)

Department of the Treasury—tnternal Revenue Service

Quarterly Federal Excise Tax Return

> For Paperwork Reduction Act Notice, see below.

OMB No. 1545-0023

Use to Report Excise
Taxes for 1982

Please enter

your name,
employer

identification

calendar

quarter of

not preprinted. L
(If not

printed,

please change.)

Note: Be sure to enter the tax on the correct line to insure proper credit.

T H
Quarter ending 7 FF —
FD
Employer identification number FP _—
! ——
T i
'
Ho

If address is
different from
prior return,
check here >

address,

number, and

return, if >

correctly

Sram Computation of Tax Items

Sal Computation of Net Tax Liability

Facilities and Services Rate Tax Ho, J 1 Total tax. Add all amounts from Part... |_$
Toll telephone service. 2... 2... 2 Adjustments. (See instructions. Attach state-
Teletypewriter exchange service . | 1% j....--| 22 ment.) woe
Local telephone service . 3 Tax as adjusted ©. 2... LE
Transportation of persons by air . 8% 26 | 4 a Record of Tax Liability. (See instructions on page 4.)
3.00 per Period Amount of Liability
Use of international air travel facilities . beets 27 Page |2St=25t_cov_- _ YW)
Transportation of property by air « 5% 28 | mist, | 16th-last day . Ws
Policies issued by foreign insurers . Loe |. 30 Total tor month JY. |
Manufacturers 7 Ist-15th day . VVVVVV
Coal (1 ton =2,000 Ibs.): Second |" th-last day YW
a Underground mined @ $1.00 per ton. . Yj, 36 Total for month | |
b Underground mined @ 4% of ton price . ef. 37 | Ist-15th_ day . Y//V/
¢ Surface mined @ S0¢ per ton . Qwxwrl). 38 Ded | toth-tast day VMI).
d Surface mined @ 4% of ton price . ) 39 Total for month fp—) |
Truck and trailer chassis and bodies; tractors . 10% 33 b Total liability for quarter . —_
Parts or accessories for trucks, etc. 8% 48 ¢ Total deposits for quarter . Lae —_
Fishing rods, and artificial lures, etc. . 10% 41 5 Overpayment from previous quarter . > |_
Bows and arrows . : 11% 6 Total deposits (item 4(c) plus item 5). . > |_
Pistols and revolvers . . . . . . 10% 32 [1 7 Undeposited taxes due (item 3 less item 6; this
Firearms (other than pistols and revolvers) 11% should be $100 or less). Pay to Internal Reve-
Shells and cartridges . 11% nue Service . > rn oe
Gasoline (manufacturers tax) . . 4¢ gal. Note: If undeposited taxes due at the end of the quarter are more than
Alcohol sold as but not used as fuel . @) $100 the entire balance must be deposited.
Lubricating of . 2. 6¢ gal. | __..-.-2----------| 2 63 | 8 if item 6 is more than item 3, enter excess here > $_.

{ highway vehicle type. .
4 laminated se

other

Inner tubes 2. 2. ew ee ee
Tread rubber (camelback) .

Fueleconomy. . 2 2 2 ee ee ee
Retail and Use Taxes

Tires

and check if you want it: ["] applied to your next return, or
J refunded to you.
9 If not liable for returns in succeeding quarters, write “FINAL” here

rm to your internal Revenue Service Center.

Diesel fuel and special motor fuels . e) | 6
Inland waterway fuel 6¢ gal. __| 64
Fuel used in Fuel other | 14¢ gal. 69
noncommercial } than gasoline |

aviation Gasoline (retailers tax) 8¢ gal. 4
Crude Oil Windfall Profit Tax

Quarterly return (attach Form 6047) . @) 50
Annual retum. 2 2. ee (*) 52
Environmental Taxes

Petroleum (Attach Form 6627)... .. . *) 53
Chemicals (Attach Form 6627) . (*) 54

‘See instructions on pages 2 and 4.

Paperwork Reduction Act Notice.—We ask for this informa-
tion to carry out the Internal Revenue laws of the United
States. 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. You are required to give us this information.

Social security number for IRS No. 52 >

Under penalties of perjury, | declare thet | have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and comp

Signature >

Title (Owner, ete.) m

Date >



General Instructions

Purpose of this Form.—Use this form to report
and pay the excise taxes listed on page 1. You must
file a return for each quarter even if you do not owe
any tax. (If you have no tax to report, write “None”
‘on lines 1 and 3.) For more information get Publica-
tion 510, Excise Taxes for 1982.

Exemptions.—Some transactions are exempt
from tax. For example, export transactions and
transactions involving States, political subdivisions,
certain nonprofit educational organizations, certain
aircraft museums, and certain helicopter usage, are
exempt.

Records.—Keep copies of your tax return, rec-
ords, and accounts of all transactions to show that
the correct tax has been paid. Keep records to sup-
port all adjustments claimed and all exemptions at
least 4 years from the latest of the following dates:
(1) when the tax became due, (2) when you paid
the tax, (3) when you claimed an adjustment, or (4)
when you filed a claim for a refund. Your records
must be available at all times for IRS inspection.

Penalties and Interest.—Avoid penalties and in-
terest by filing returns and depositing and paying
taxes when due. The law provides penalties for:

@ Filing a return late, 5% of the tax per month,
or part of a month, the return is late (maximum
25%).

g taxes late, 5% of the underpay-

@ Overstating deposits, 25% of the overstate-
ment.

@ Paying taxes late, 1% of 1% of the unpaid
amount for each month or part of a month it re-
mains unpaid—up to 25% of the unpaid amount.
The penalty applies to unpaid tax shown on a re-
turn and to any part of additional tax shown on a
bill if it is not paid within 10 days from the date of
the bill.

If you can show reasonable cause for late filing,
late payment, or not depositing the proper amount
of tax when due, the penalty does not apply. If
you are late filing a return or depositing taxes,
send in a full explanation with the return.

@ Willfully failing to collect and pay tax, keep
records, or file returns, 100%.

@ Filing false or fraudulent returns, 50% of the
underpayment plus 50% of the interest attributable
to the underpayment.

These penalties are in addition to the interest
charge on late payments.

Also, be sure to sign the return. An unsigned re-
turn is'not considered filed.

When to File.—You must file a return for each
quarter of the calendar eat as follows:

A ars ‘han Air trans.,
Quarter covered | tr and | comm and
mina rot ‘due by
January, February,

March _ April 30. May 31
April, May, June. July 31. August 31
July, August,

September... October 31... November 30
October, Novemt

January 31_ February 28

For excise taxes other than those on air trans-
portation, communications, or windfall profits you
may have an additional 10 days to file your return
if it shows that you have made deposits of the
taxes due for the quarter on time and in full.

If you are reporting two or more excise taxes,
and they are due on different dates, the later filing
date will be acceptable providing timely deposits
were made, Only one return should be filed each
quarter.

Where to File.—

Ut your principal business, office
ney, OF legal residence
individual,

File with the Internal
Revenue Servi
Center at

4

Holtsville, NY 00501

foca

4

New Jersey, New York City and
counties of Nassau, Rockland,
Suffolk, and Westchester

New York (all other counties),
Connecticut, Maine,

Massachusetts, New Hampshire, Andover, MA 05501
Rhode Island, Vermont

District of Columbi e,

Marviand, Pennsylvania "TM'"' Philadelphia, PA 19255

Page 2

Alabama, Florida, Georgia,

Mississippi, South Carolina Atlanta, GA 31101
Michigan, Ohio Cincinnati, ON 45999
‘Arkansas, Kansas, Louisiana,

New Mexico, Oklahoma, Texas Austin, TR 73301
‘Alaska, Arizona, Colorado, idaho,

Minnesota, Montana, Nebraska,

Nevada, North Dakota, Oregon, Ogden, UT 84201

South Dakota, Utah, Washington

Wyoming
iinois, lowa, Missouri, it

Miois. Kansas City, MO 64999
California, Hawaii Fresno, CA 93888
Indiana, Kentucky, North

Carolina, Tennessee, Memphis, IN 37501

Virginia, West Virginia

Tf you have no legal residence, principal place of
business or principal office or agency in any Internal
Revenue district, file your return with the Internal
Revenue Service Center, Philadelphia, PA 19255.

Specific Instructions

These instructions explain how to complete
Form 720. Line items with no instructions are self-
explanatory.

Name, Address, and Employer Identification
Number.—The first time you file Form 720, enter
the required information. After this, IRS will mail
you a preaddressed return every 3 months. Please
use the preaddressed form.

If you use a non-preaddressed form, type or print
your name, address, and employer ‘identification
number (EIN) exactly as shown on earlier returns.
Do not use an EIN of a former owner of a business.
For information on applying for an EIN, or filing a
return if the EIN has not been received, see Pub-
lication 583, Information for Business Taxpayers—
Business Taxes, Identification Numbers, Record-
keeping.

Tax Computation Columns.—Figure the taxes
that apply by using the appropriate figures in the
“rate” columns. Add the amounts of tax in the
columns and enter the total tax on line 1.

Facilities and Services

a. Communications services.—Amounts paid for
communication services do not include State or
if the amount is separately stated
in the bill to the customer.

b, Policies issued by foreign insurers.—Tax rates
are as follows:

(1) Casualty insurance and indemnity bonds.—4¢
on each dollar (or fraction of a dollar) of the pre-
mium paid on the policy or bond.

(2) Life insurance, sickness and accident policies,
and annuity contracts.—1¢ on each dollar (or frac:
tion of a dollar) of the premium paid on the policy
or contract.

(3) Reinsurance,—1¢ on each dollar (or fraction
of a dollar) of the premium paid on the policy of
reinsurance covering any of the contracts taxable
in (1) or (2) above.

Manufacturers

These taxes apply to the sale or use by the manu-
facturer, producer, or importer of the articles listed.
These taxes may also apply to one part of an othe
wise nontaxable article, such as tires on imported
vehicles.

See Publication 510 for information on tax-free
purchases of parts and accessories, tires, tubes, or
tread rubber and using Form 637, Certificate of
Registry.

a. Basis for tax and adjustment—Compute the
tax on the price for which the taxable article is sold
or leased. For a taxable article that is sold or leased
under a conditional sales contract, installment pay-
ment contract, or chattel mortgage arrangement,
compute and pay the tax on each payment received
during the quarter covered by the return. For exclu-
sion from the sale price of finance charges and local
advertising charges, see Publication 510. There are
also special rules that apply to the lease of any
article.

You may adjust the price by deducting charges
for transportation, delivery, insurance, and retail
dealer preparation costs that are included the
manufacturers sale price. See the applicable regu-
lations and Publication 510 for the circumstances
under which you may make adjustments and the
evidence you need to support adjustments. You may
also adjust the manufacturers sale price for dis-

counts, rebates, and similar allowances granted to
the purchaser. You may not anticipate such dis-
counts. The purchaser must have taken the discount
before the return is required to be filed.

If you make adjustments or get the required
evidence after you file your return, you may be able
to take a credit on a later return or file a refund
claim.

You must compute the tax on a price established
by the Commissioner of Internal Revenue if an
article is sold by the manufacturer or producer at
retail, on consignment, or in a way other than
through an arm’s-length transaction at less than
the fair market price; or if an article is used by the
manufacturer or producer in a manner subject to
tax.

b. Coal.—The tax on coal per ton (2,000 Ibs.)
may not be more than 4% of the price at which a
ton of coal is sold in each category. For more in-
formation on this tax see Publication 510.

c. Trucks.—The resale of an article taxable as
the ‘chassis or body of a truck, truck tractor, or
truck-trailer is not subject to additional manufac-
turers tax if before the resale the chassis or body
was merely combined with certain items, such as
a fifth wheel, wrecker crane, or loading and unload-
ing equipment. For a full list of such items, see
section 4063(d) of the Internal Revenue Code.

Light-duty trucks.—No excise tax is imposed on
the sale by a manufacturer, producer, or importer
of a light-duty truck or any article that the purchaser
(2) will resell on or in connection with the first retail
Sale of a light-duty truck; or (2) will resell to a
second purchaser for resale on or in connection with
the first retail sale of a light-duty truck. See sec-
tion 4061(a)(2) for a definition of a light-duty
truck.

d. Alcohol sold as but not used as a fuel.—Alco-
hol, either mixed or straight, designated for use as
fuel is eligible for a credit. Form 6478, Credit for
Alcohol Used as Fuel, is used to compute the cred-
it. If the credit is allowable and any person later
either (1) uses a mixture or straight alcohol for a
purpose other than fuel, (2) separates the alcohol
from the mixture, or (3) mixes the straight alcohol,
an excise tax is imposed. The tax is 40¢ a gallon
for each gallon of alcohol that is at least 190 proof
and 30¢ a gallon for each gallon of alcohol that is
at least 150 proof but less than 190 proof.

e. Tread rubber.—If a tire, exported from the
United States, is recapped or retreaded (other than
bead to bead) outside the U.S., and then is im-
ported into the U.S., the importer is liable for the
excise tax on tread rubber. See section 4071(f) for
more information.

f. Fuel economy.—Compute the tax on Form
6197, Fuel Economy Tax, and report it quarterly
‘on Form 720. File Form 6197 annually as an attach
ment to Form 720.

Retail and Use Taxes

The tax rates for diesel fuel and special motor
fuels are as follows:

(a) 4 cents a gallon on diesel fuel if sold for use
or used in a highway motor vehicle and 4 cents a
gallon on special motor fuel if sold for use in a
motor vehicle or motorboat (other than commercial
fishing boats) unless (1) or (2) below applies:

(1) 2 cents a gallon on diesel fuel sold for use
or used in a highway motor vehicle either: At the
time of sale or use is not registered and is not
required to be registered for highway use under
the laws of any State or foreign country, or in the
case of a highway vehicle owned by the United
States, is not used on the highway.

(2) 2 cents a gallon on special motor fuels sold
for use in a motor vehicle which meets the qualifica-
tions in (1) above, that also is used in a trade or
business.

(b) If fuel is sold subject to the 2-cents-a-gallon
rate (see (1) and (2) above), there is an additional
tax of 2 cents a gallon on the user, if the fuel is
used in a motor vehicle or motorboat where the use
is subject to the 4 cents a gallon rate. The addi-
tional 2¢-a-gallon tax is reported and paid on Form
720 on the line for IRS No. 61.

If the 4¢-a-gallon tax has been paid and the fuel
is used for a purpose described in (1) or (2) above
subject to the 2¢-a-gallon rate, a credit may be ob-
tained. See Form 4136, Computation of Credit for
Federal Tax on Gasoline, Special Fuels, and Lubri-
cating Oil.

(instructions continued on page 4)


rom 120

(Rev. Oct. 1982)

Department of the Treasury—internal Revenue Service

Quarterly Federal Excise Tax Return

> For Paperwork Reduction Act Notice, see below.

OMB No. 1545-0023

Use to Report Excise
Taxes for 1982

Type or print in this space your name, address, and employer identification number

as shown on original.

Return for calendar quarter ending
(Enter month and year as on original)

YOUR COPY

BEZEA Computation of Tax Items

[ETA Computation of Net Tax Liability

Facilities and Services

Toll telephone service . .
Teletypewriter exchange service .
Local telephone service .
Transportation of persons by air.

Use of international air travel facilities .
Transportation of property by air .
Policies issued by foreign insurers .
Manufacturers

Coal (1 ton=2,000 Ibs.):

a Underground mined @ $1.00 per ton .

b Underground mined @ 4% of ton price .

¢ Surface mined @ 50¢ per ton .

d Surface mined @ 4% of ton price .
Truck and trailer chassis and bodies; tractors .
Parts or accessories for trucks, etc. .

Fishing rods, and artificial lures, etc. .
Bows and arrows. . . - 7 ee we
Pistols and revolvers

Firearms (other than pistols and revolvers) .
Shells and cartridges .

Gasoline (manufacturers tax) .

Alcohol sold as but not used as fuel .

Lubricating oil
{ highway vehicle type -

Rate

1%

8%

$3.00 per
person

Tax

IRS.
No.
22

26

27
28
30

36
37
38
39
33
48
41
44

1 Total tax. Add all amounts from Part |. $
2 Adjustments. (See instructions. Attach state-
ment.)
$

3 Tax as adjusted
4 a Record of Tax_Liability. ‘Gee instructions ¢ on page a

Total to ont | —o
Second ane — ae
uh | MA“,

WM

b Total liability for quarter .
¢ Total deposits for quarter .
5 Overpayment from previous quarter .
6 Total deposits (item 4(c) plus item 5) .

| Total for month

>
>

Tires | laminated _
other... ee 66

Inner tubs . 2... ee 67

Tread rubber (camelback) . 68

Fuel economy. 2 2. 2 ee ee 40

Retail and Use Taxes

Diesel fuel and special motor fuels. . . . . @) | 61

Inland waterway fuel 6¢ gal. —_| 64

Fuel used in Fuel other |} 14¢ gal. 69

noncommercial } than gasoline |

aviation Gasoline (retailers tax) 86 gal fe 4

Crude Oil Windfall Profit Tax

Quarterly return (attach Form 6047) . e) 50

Annual return. . 2 2 2 2 @) 52

Environmental Taxes

Petroleum (Attach Form 6627) . (nn 53

Chemicals (Attach Form 6627) . @) 54

“See instructions on pages 2 and 4.

32 || 7 Undeposited taxes due (item 3 less item 6; this

AG should be $100 or less). Pay to Internal Reve-

49 nue Service i
62 Note: If undeposited taxes due at the end of the quarter are more than
51 $100 the entire balance must be deposited.

63 Jf 8 If item 6 is more than item 3, enter excess here > $__.

and check if you want it: (j applied to your next return, or
[DJ refunded to you.
9 If not liable for returns in succeeding quarters, write “FINAL” here

Paperwork Reduction Act Notice.—We ask for this informa-
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Social security number for IRS No. 52 >

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Signature

Title (Owner, ete.

ies of perjury, | declare that | have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, itis true, correct and complete,

dm Date >

Form 720 (rev. 10-82)