Amount of refund

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

OMB No. 1545-1420

Other Claims

(Rev. January 2009)

Department of the Treasury

Internal Revenue Service

Schedule 6

(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. 1-2009)

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 ©

$

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.

Purpose of schedule. Use Schedule 6 for claims not reportable

on Schedules 1, 2, 3, 5, and 8, including refunds of excise taxes

reported on:

● Form 720, Quarterly Federal Excise Tax Return;

● 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;

What’s New

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 attach additional sheets, write your name and

taxpayer identification number on each sheet.

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

reported on Forms 720 filed for prior quarters. Instead, 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. General Instructions

For Form 720 claims under credit reference numbers (CRNs)

396, 304, and 305, include the number of taxable tires for each

CRN included in the claim.
Schedule 6 (Form 8849) (Rev. 1-2009) Page 2

4. How you figured the claim amount.

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

Form 2290, CRN 365

A claim for refund may be made for the following:

1. The vehicle identification number (VIN).

2. Whether the vehicle was sold, destroyed, or stolen.

3. Date of the sale, accident, or theft.

4. Computation of the refund amount. See the line 5

instructions for Form 2290.

Form 730, CRN 368

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 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,

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 Schedule 6.

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.

Tax CRN

Ozone-depleting chemicals

Truck, trailer, and semitrailer chassis and bodies,

and tractors

Passenger vehicles (luxury tax)

Gas guzzler automobiles

Vaccines

Sport fishing equipment

Electric outboard motors

Bows, quivers, broadheads, and points

398

383

392

340

397

341

342

344

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

vehicle is registered at the time it was sold, 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.

Fishing tackle boxes 387

Arrow shafts 389

Taxable tires other than biasply or 

super single tires

Taxable tires, biasply or super single tires

Taxable tires, super single tires 

designed for steering

396

304

305

Fishing rods and fishing poles 308

Claimant must be registered by the IRS and must enter their

registration number on the statement.

Diesel-water fuel emulsion blending (CRN 310). The claim rate

for undyed diesel fuel taxed at $.244 (CRN 310) and used to

produce a diesel-water fuel emulsion is $.046 per gallon of diesel

fuel (blender claims).

Claim requirements. The amount claimed must be at least

$750. This amount may be met by making a claim during any

quarter of a claimant’s income tax year or aggregating amounts

from any quarters of the claimant’s income tax year for which no

other claim has been made. The amount claimed for a

diesel-water fuel emulsion may be combined with any amounts

claimed on Schedule 1 to meet the $750 minimum. The claim

must be filed during the first quarter following the last quarter

included in the claim. Only one claim may be filed per quarter.

Enter the earliest and latest date of the claim on page 1. If the

above requirements are not met, see Annual Claims in the Form

8849 instructions.

In addition to items 1–5 above, claimant must attach a

statement certifying that (a) the claimant produced a diesel-water

fuel emulsion containing at least 14% water, (b) the emulsion

additive is registered by a United States manufacturer with the

Environmental Protection Agency (EPA) under section 211 of the

Clean Air Act, (c) the claimant used undyed diesel fuel taxed at

$.244 to produce the diesel-water fuel emulsion and (d) the

claimant sold or used the diesel-water fuel emulsion in its trade

or business.

● 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.

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

that was sold, destroyed, or stolen before June 1 of any period

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

To make a claim for a vehicle that was sold, destroyed, or

stolen, the following information must be attached to 

Schedule 6.

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

Pub. 510, Excise Taxes, 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.

Form 720

3. The amount of the claim. If the claim is for more than one

quarter, list the claim amounts by quarter.

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

the government.

6. For CRNs 396, 304, and 305, include the number of taxable

tires for each CRN included in the claim.