Amount of refund

Use the space below for an explanation of each tax claimed. 

Other Claims OMB No. 1545-1420

(Rev. January 2003)

Schedule 6 Department of the Treasury—Internal Revenue Service

(Form 8849)

 Attach to Form 8849.

For Privacy Act and Paperwork Reduction Act Notice, see Form 8849 instructions. Cat. No. 27454M Schedule 6 (Form 8849) (Rev. 1-2003)

Name as shown on Form 8849 Total refund (total of lines 1–5)

1

2

3

4

5

Tax

Enter the earliest and latest dates of the events included in this claim. Enter in MMDDYYYY format.

Earliest date  Latest date 

Claimant’s registration number for Section 4091(d) claims. 

$

EIN or SSN

$

CRN

For claims under section 6416(b)(2) relating to certain uses and resales of certain articles subject to manufacturers or retailers

taxes, claimant certifies that it sold the article at a tax-excluded price, repaid the amount of tax to the ultimate vendor, or has

obtained the written consent of the ultimate vendor to make the claim; and has the required supporting evidence.

Instructions

Section references are to the Internal Revenue Code unless

otherwise noted.

Caution: Do not use Schedule 6 to make adjustments to liability

reported on Forms 720 filed for prior quarters. Use Form 720X,

Amended Quarterly Federal Excise Tax Return. Also, do not use

Schedule 6 to claim amounts that were taken or will be taken as

a credit on Form 2290 or Form 730. Purpose of schedule. Use Schedule 6 for claims not reportable

on Schedules 1–5, including refunds of excise taxes reported on:

● Form 720, Quarterly Federal Excise Tax Return, including

section 4091(d) claims;

● Form 730, Monthly Tax Return for Wagers; and

● Form 11-C, Occupational Tax and Registration Return for

Wagering.

● Form 2290, Heavy Highway Vehicle Use Tax Return;

Claim requirements. Generally, a claim must be filed within 3

years of the filing of the return to which the claim relates, or 2

years from when the tax reported on that return was paid,

whichever is later.

How to file. Attach Schedule 6 to Form 8849. Mail it to the IRS

at the address under Where To File in the Form 8849

instructions. If you are filing a Section 4091(d) claim, write

“Section 4091(d)” at the top of Form 8849 and on the envelope.

If you attach additional sheets, write your name and taxpayer

identification number on each sheet.
Schedule 6 (Form 8849) (Rev. 1-2003) Page 2

A claim relating to the taxes listed below may be made. See

Pub. 510, Excise Taxes for 2003, for information on allowable

claims relating to these taxes. The following information must be

attached to the claim.

1. A detailed description of the claim.

2. Any additional information required by the regulations.

3. The amount of the claim.

4. How you figured the claim amount.

5. Any other information you believe will support the claim.

Section 4091(d), CRN 369

Caution: This claim cannot be filed with any other claim. See

Schedules Attached on Form 8849.

If a registered aviation fuel producer bought aviation fuel on

which tax was paid to the government, then a claim for refund of

the tax may be made.

Claimant. The registered producer that bought taxed aviation

fuel is the only person eligible to make this claim.

Claim requirement. Attach all of the following information to

Schedule 6:

1. Volume and type of aviation fuel.

2. Date on which the second producer acquired the aviation

fuel included in the claim.

3. Amount of tax that the first producer paid to the

government.

5. A copy of the First Producer’s Report that relates to the

aviation fuel covered by the claim.

6. A copy of any Statement of Subsequent Seller that the

second producer received with respect to that aviation fuel.

Form 2290, CRN 365

A claim for refund may be made for the following:

● A pro rata refund of the tax paid on Form 2290 for a vehicle

that was destroyed or stolen before June 1 of any period (July

1–June 30) and subsequently not used during the period. To

1. The vehicle identification number (VIN).

2. Whether the vehicle was destroyed or stolen.

3. Date of the accident or theft.

4. Computation of the refund amount. See the line 4

instructions for Form 2290.

● Any vehicle on which the tax was paid on Form 2290 if the

vehicle was used 5,000 miles or less on public highways (7,500

or less for agricultural vehicles) during the period (July 1–June

30). The mileage limitation applies to the total mileage a vehicle

is driven during a period regardless of the number of owners of

the vehicle. A claim for this mileage refund cannot be filed until

after June 30 of the period.

Form 730, CRN 368

4. If the fuel was sold, a statement certifying that the amount

of the prior tax has not been included in the price of the fuel and

has not been collected from the purchaser by the claimant.

Form 11-C, CRN 367

A claim for refund may be made for overpayment of tax due to a

mistake in tax liability previously reported on Form 11-C.

A claim for refund may be made for the following:

● An overpayment of tax. The claim is not allowed unless a

statement of the facts is attached that includes the following

information.

1. An explanation of the reason for claiming a refund.

2. The date of payment and the amount of the tax.

3. Whether any previous claim covering the amount involved,

or any part, has been filed.

4. A statement that you:

a. Have not collected (whether as a separate charge or

otherwise) the amount of the tax from the person that placed the

wager on which the tax was imposed, or

b. Have repaid the amount of the tax to the person that

placed the wager, or

c. Have the written consent of the person that placed the

wager to the making of the refund (the consent must be

attached to the claim).

5. If the overpayment relates to a laid-off wager accepted by

you, one of the above three statements must be attached for

both the person that placed the laid-off wager and the person

that placed the original wager.

● Credit for wagers laid off by you. If you accept a wager and

lay off all or part of the wager with a person who is liable for the

tax and have paid the tax, a claim may be allowed for the tax

paid on the laid off amount. No claim is allowed unless the

following information is attached to the claim.

1. The certificate described in Regulations section

44.6419-2(d).

2. A statement that includes: (a) the reason for the refund, (b)

the month in which the tax was paid, (c) the date of payment,

and (d) whether any previous claim covering the amount

involved, or any part, has been filed.

Form 720

Tax CRN

Ozone-depleting chemicals

Truck, trailer, and semitrailer chassis and

bodies, and tractors

Passenger vehicles (luxury tax)

Highway-type tires

Gas guzzler automobiles

Vaccines

Sport fishing equipment

Electric outboard motors and sonar devices

Bows

Arrow components

398

383

392

366

340

397

341

342

370

344

Claimant. The claim is made by the person in whose name the

vehicle is registered at the time it was destroyed or stolen.

Claimant. The claim is made by the person that paid the tax to

the government.

Claimant. The claim is made by the person that paid the tax to

the government.

● An overpayment of tax due to a mistake in tax liability

previously reported on Form 2290.

Claimant. The claim is made by the person that paid the tax to

the government.

Claimant. The claim is made by the person that paid the tax to

the government.

Claimant. The claim is made by the person that paid the tax to

the government.

make a claim for a vehicle that was destroyed or stolen, the

following information must be attached to Schedule 6: