Form 2290

(Rev. July 2012)

Department of the Treasury 

Internal Revenue Service (99)

Heavy Highway Vehicle Use Tax Return

For the period July 1, 2012, through June 30, 2013

▶ Attach both copies of Schedule 1 to this return.

▶ For information about Form 2290 and its instructions, go to www.irs.gov/form2290.

Keep a copy of this 

return for your records.

OMB No. 1545-0143

Type 

or Print

Name Employer identification number

–

Address (number, street, and room or suite no.)

City, state, and ZIP code (For Canadian or Mexican address, see the separate instructions.)

Check if applicable:

Address change VIN Correction 

Check this box if you are correcting a vehicle 

identification number (VIN) listed on a previously filed 

Schedule 1 (Form 2290). Do not check this box for any 

other reason.

Amended Return 

Check this box if reporting (a) additional tax from an 

increase in taxable gross vehicle weight or (b) suspended 

vehicles exceeding the mileage use limit. Do not check 

this box for any other reason.

Final Return 

Check this box if you no longer have taxable vehicles to 

report.

Part I Figuring the Tax

1 Was the vehicle(s) reported on this return used on public highways during July 2012? If YES, 

enter 201207 in the boxes to the right. If NO, see the table on page 3 of the instructions . ▶ 1

Y Y Y Y M M

2 Tax. Enter the Total from Form 2290, page 2, column (4) . . . . . . . . . . . ▶ 2 .

3 Additional tax from increase in taxable gross weight (see instructions) . . . . . . . ▶ 3 .

4 Total tax. Add lines 2 and 3 . . . . . . . . . . . . . . . . . . . . . ▶ 4 .

5 Credits (see instructions) . . . . . . . . . . . . . . . . . . . . . . ▶ 5 .

6 Balance due. Subtract line 5 from line 4. This is the amount you owe. If payment through

EFTPS, check here . . . . . . . . . . . . . . . . . . . . . . ▶ 6 .

Part II Statement in Support of Suspension (Complete the statements that apply. Attach additional sheets if needed.)

7 I declare that the vehicles reported on Schedule 1 as suspended (category W) are expected to be used on public highways

(check the boxes that apply): 5,000 miles or less 7,500 miles or less for agricultural vehicles

during the period July 1, 2012, through June 30, 2013, and are suspended from the tax. Complete and attach Schedule 1.

8 a I declare that the vehicles listed as suspended on the Form 2290 filed for the period July 1, 2011, through June 30, 2012, were 

not subject to the tax for that period except for any vehicles listed on line 8b. Check this box if applicable. ▶

b Vehicle identification numbers

9 I declare that vehicle identification numbers

were listed as suspended on the Form 2290 filed for the period July 1, 2011, through June 30, 2012. These vehicles were sold or 

transferred to on , .

At the time of the transfer, the vehicles were still eligible for the suspension of the tax. Attach a separate list if needed.

Third 

Party 

Designee

Do you want to allow another person to discuss this return with the IRS (see instructions)? Yes. Complete the following. No

Designee’s 

name ▶

Phone 

no. ▶

Personal identification 

number (PIN) ▶

Sign 

Here

Under penalties 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. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

▲

Signature

▲

Date

Type or print name below signature. Telephone number

Paid 

Preparer 

Use Only

Print/Type preparer’s name Preparer's signature Date

Check if 

self-employed

PTIN

Firm’s name ▶ Firm's EIN ▶

Firm's address ▶ Phone no.

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 11250O Form 2290 (Rev. 7-2012) 
Form 2290 (Rev. 7-2012) Page 2 

Tax Computation

Category

Taxable gross weight 

(in pounds)

(1) 

Annual tax 

(vehicles used 

during July)

(a) 

Vehicles 

except 

logging*

(b) 

Logging 

vehicles*

(2) 

Partial-period tax 

(vehicles first used after July) 

See the tables at the end of 

the separate instructions.

(a) 

Vehicles 

except logging*

(b) 

Logging 

vehicles*

(3) 

Number of 

vehicles

(a) 

Vehicles 

except logging*

(b) 

Logging 

vehicles*

(4) 

Amount of tax 

(col. (1) or (2) 

mutiplied by 

col. (3))

Category

. . . . . . . . . .

$ $ $

Totals. Add the number of vehicles in columns (3a) and (3b). Enter the total here 

(this should be the same total of taxable vehicles shown on Schedule 1, Part II, line c). 

Add the amounts in column (4). Enter the total here and on Form 2290, line 2 . . ▶ $

w

Tax-Suspended Vehicles 

(See Part II on page 6 of 

the instructions.) 

Complete both copies of Schedule 1 (Form 2290) and attach them to Form 2290.

* See page 2 of the instructions for information on logging vehicles.

Form 2290 (Rev. 7-2012) 
SCHEDULE 1 

(Form 2290)

(Rev. July 2012)

Department of the Treasury 

Internal Revenue Service 

Schedule of Heavy Highway Vehicles

For the period July 1, 2012, through June 30, 2013

▶ Complete and file both copies of Schedule 1. One copy will be stamped and returned to 

you for use as proof of payment when registering vehicle(s) with a state.

OMB No. 1545-0143

Type 

or Print

Name Employer identification number

–

Address (number, street, and room or suite no.)

City, state, and ZIP code (For Canadian or Mexican address, see the separate instructions.)

Part I Vehicles You Are Reporting (enter VIN and category)

Category A through W 

(category W for 

suspended vehicles)

1 

2 

3 

4 

5 

6

7

8

9

10

11

12

13 

14 

15 

16 

17

18

19

20

21 

22 

23 

24 

Part II Summary of Reported Vehicles

a Total number of vehicles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a 

b Enter the total number of taxable vehicles on which the tax is suspended (category W) . . . . . . . . b 

c Total number of taxable vehicles. Subtract line b from line a . . . . . . . . . . . . . . . . . c

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 11250O Schedule 1 (Form 2290) (Rev. 7-2012)
THIS PAGE INTENTIONALLY LEFT BLANK
SCHEDULE 1 

(Form 2290)

(Rev. July 2012)

Department of the Treasury 

Internal Revenue Service 

Schedule of Heavy Highway Vehicles

For the period July 1, 2012, through June 30, 2013

▶ Complete and file both copies of Schedule 1. One copy will be stamped and returned to 

you for use as proof of payment when registering vehicle(s) with a state.

OMB No. 1545-0143

Type 

or Print

Name Employer identification number

–

Address (number, street, and room or suite no.)

City, state, and ZIP code (For Canadian or Mexican address, see the separate instructions.)

Part I Vehicles You Are Reporting (enter VIN and category)

Category A through W 

(category W for 

suspended vehicles)

1 

2 

3 

4 

5 

6

7

8

9

10

11

12

13 

14 

15 

16 

17

18

19

20

21 

22 

23 

24 

Part II Summary of Reported Vehicles

a Total number of vehicles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a 

b Enter the total number of taxable vehicles on which the tax is suspended (category W) . . . . . . . . b 

c Total number of taxable vehicles. Subtract line b from line a . . . . . . . . . . . . . . . . . c

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 11250O Schedule 1 (Form 2290) (Rev. 7-2012)
THIS PAGE INTENTIONALLY LEFT BLANK
Schedule 1 (Form 2290) (Rev. 7-2012)

Consent to Disclosure of Tax Information

For the period July 1, 2012, through June 30, 2013

By signing, dating, and entering my employer identification number below, I hereby consent to the 

Internal Revenue Service (IRS) disclosing information about my payment of the heavy highway 

vehicle use tax (HVUT) for the tax period listed above to the federal Department of Transportation 

(DOT), U.S. Customs and Border Protection (CBP), and to state Departments of Motor Vehicles 

(DMV). The information disclosed to the DOT, CBP, and state DMVs will be my vehicle identification 

number (VIN) and verification that I have paid the HVUT. The IRS may disclose the information to the 

DOT, CBP, and to the DMVs of the 50 states and the District of Columbia who have other taxing, 

registration, or information collecting authority. I agree that the American Association of Motor 

Vehicle Administrators (AAMVA), a third-party nonprofit organization, may be used as an 

intermediary to transmit my VIN and payment information from the IRS to the state DMVs.

I understand that the information to be disclosed is generally confidential under the laws 

applicable to the IRS and that the agency receiving the HVUT information is not bound by these laws 

and may use the information for any purpose as permitted by other federal laws and/or state law. To 

be effective, this consent must be received by the IRS within 120 days of the date below.

If signed by a corporate officer or party other than the taxpayer, I certify that I have the authority to 

execute this consent to disclosure of tax information.

Sign 

Here

▶

Signature

▶

Date

Type or print name below signature.

▶

Employer identification number

–

Schedule 1 (Form 2290) (Rev. 7-2012)
Form 2290-V, Payment Voucher

Purpose of Form

Complete Form 2290-V if you are making a payment by 

check or money order with Form 2290, Heavy Highway 

Vehicle Use Tax Return. We will use Form 2290-V to 

credit your payment more promptly and accurately, and 

to improve our service to you.

If you have your return prepared by a third party and a 

payment is required, provide Form 2290-V to the return 

preparer.

Do not file Form 2290-V if you are paying the balance 

due on Form 2290, line 6, using the Electronic Federal 

Tax Payment System (EFTPS) or electronic funds 

withdrawal (direct debit). See How to Pay the Tax in the 

Instructions for Form 2290.

Specific Instructions

Box 1. If you do not have an EIN, you may apply for one 

online. Go to the IRS website at 

www.irs.gov/businesses/small and click on the “Employer 

ID Numbers (EINs)” link. You may also apply for an EIN by 

calling 1-800-829-4933, or you can fax or mail Form 

SS-4, Application for Employer Identification Number, to 

the IRS.

Box 2. Enter the amount paid from Form 2290, line 6.

Box 3. Enter the date as shown on Form 2290, line 1. 

Box 4. Enter your name and address as shown on Form 

2290.

• Enclose your check or money order made payable to 

“United States Treasury.” Be sure to enter your EIN, 

“Form 2290,” and the tax period on your check or money 

order. Do not send cash. Do not staple Form 2290-V or 

your payment to Form 2290 (or to each other).

• Detach Form 2290-V and send it with your payment and 

Form 2290 to the address shown in the bottom left corner 

of Form 2290-V. 

▲ Detach here ▲

Form

2290-V

(Rev. July 2012)

Department of the Treasury 

Internal Revenue Service 

Payment Voucher

For the period July 1, 2012, through June 30, 2013 

▶ See How To Pay the Tax in the Instructions for Form 2290. 

▶ Do not staple or attach this voucher or your payment to your return.

OMB No. 1545-0143

1 Employer identification number

–

2 Enter the amount of your payment. Make 

your check or money order payable to 

“United States Treasury” 

Dollars Cents

3 Enter date as shown on line 1 of Form 2290.

Y Y Y Y M M

Send Form 2290, this voucher, and payment to:

Internal Revenue Service 

P.O. Box 804525 

Cincinnati, OH 45280-4525

4 Name

Address

City, state, and ZIP code (For Canadian or Mexican address, see the Instructions for Form 2290.)