Form 2290

(Rev. July 2009)

Department of the Treasury 

Internal Revenue Service (99)

Heavy Highway Vehicle Use Tax Return

For the period July 1, 2009, through June 30, 2010

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 page 5 of the instructions.)

FOR IRS 

USE ONLY

T

FF

FP

I

T

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 2009? If YES, 

enter 200907 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 page 5 of the instructions . . © 3 .

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

5 Credits. See page 5 of the 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 listed in Part II of Schedule 1 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, 2009, through June 30, 2010, and are suspended from the tax. Complete and attach Schedule 1.

8a I declare that the vehicles listed as suspended on the Form 2290 filed for the period July 1, 2008, through June 30, 2009, 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, 2008, through June 30, 2009. 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, they are 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’s 

Use Only

Preparer’s 

signature © Date Check if 

selfemployed

Preparer’s SSN or PTIN

Firm’s name (or 

yours if self-employed), 

address, and ZIP code © EIN

Phone no.

For Privacy Act and Paperwork Reduction Act Notice, see page 9 of the instructions. Cat. No. 11250O Form 2290 (Rev. 7-2009) 

© Attach both copies of Schedule 1 to this return.

© See the separate instructions.
Form 2290 (Rev. 7-2009) Page 2 

Tax Computation

Category

(1) 

Annual tax 

(vehicles used 

during July)

(2) 

Partial-period tax 

(vehicles first used after July) 

(See the tables on page 10 of 

the instructions.)

(3) 

Number of 

vehicles

(4) 

Amount of tax 

(col. (1) or (2) 

times col. (3))

Category

Taxable Gross Weight 

(in pounds)

(a) 

Vehicles 

Except Logging*

(b) 

Logging 

Vehicles*

(a) 

Vehicles 

Except Logging*

(b) 

Logging 

Vehicles*

(a) 

Vehicles 

Except Logging*

(b) 

Logging 

Vehicles*

A 55,000 $100.00 $75.00 $ $ $ A

B 55,001 – 56,000 122.00 91.50 B

C 56,001 – 57,000 144.00 108.00 C

D 57,001 – 58,000 166.00 124.50 D

E 58,001 – 59,000 188.00 141.00 E

F 59,001 – 60,000 210.00 157.50 F

G 60,001 – 61,000 232.00 174.00 G

H 61,001 – 62,000 254.00 190.50 H

I 62,001 – 63,000 276.00 207.00 I

J 63,001 – 64,000 298.00 223.50 J

K 64,001 – 65,000 320.00 240.00 K

L 65,001 – 66,000 342.00 256.50 L

M 66,001 – 67,000 364.00 273.00 M

N 67,001 – 68,000 386.00 289.50 N

O 68,001 – 69,000 408.00 306.00 O

P 69,001 – 70,000 430.00 322.50 P

Q 70,001 – 71,000 452.00 339.00 Q

R 71,001 – 72,000 474.00 355.50 R

S 72,001 – 73,000 496.00 372.00 S

T 73,001 – 74,000 518.00 388.50 T

U 74,001 – 75,000 540.00 405.00 U

V Over 75,000 550.00 412.50 V

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

and on Schedule 1, Part III, line a. 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. 7-2009) 
SCHEDULE 1 

(Form 2290)

(Rev. July 2009)

Department of the Treasury 

Internal Revenue Service 

Schedule of Heavy Highway Vehicles

For the period July 1, 2009, through June 30, 2010

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

© See the Consent to Disclosure of Tax Information on page 2.

OMB No. 1545-0143

Type 

or Print

Name as shown on Form 2290 Employer identification number

–

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

City, state, and ZIP code (For Canadian or Mexican address, see page 5 of the instructions.)

FOR IRS 

USE ONLY

T

FF

FP

I

T

Caution. You must list all vehicles. Attach a separate list if needed. See page 7 of the instructions.

Part I Vehicles on Which You Are Reporting Tax. Enter VIN and category. Category

1 

2 

3 

4 

5 

Part II Vehicles for Which Tax Is Suspended—5,000 Miles or Less (7,500 Miles or Less for 

Agricultural Vehicles). Enter VIN. Category

1 W 

2 W 

Part III Summary of Reported Vehicles

a Enter the number of taxable vehicles from Form 2290, page 2, column 3, Totals . . . . . . . . . . . a 

b Enter the total number of taxable vehicles on which the tax is suspended from Form 2290, page 2, column 3 (category W) b 

For Privacy Act and Paperwork Reduction Act Notice, see page 9 of the instructions. Schedule 1 (Form 2290) (Rev. 7-2009)

Do not cut or separate the forms on this page.

SCHEDULE 1 

(Form 2290)

(Rev. July 2009)

Department of the Treasury 

Internal Revenue Service 

Schedule of Heavy Highway Vehicles

For the period July 1, 2009, through June 30, 2010

This 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 as shown on Form 2290 Employer identification number

–

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

City, state, and ZIP code (For Canadian or Mexican address, see page 5 of the instructions.)

Caution. You must list all vehicles. Attach a separate list if needed. See page 7 of the instructions.

Part I Vehicles on Which You Are Reporting Tax. Enter VIN and category. Category

1 

2 

3 

4 

5 

Part II Vehicles for Which Tax Is Suspended—5,000 Miles or Less (7,500 Miles or Less for 

Agricultural Vehicles). Enter VIN. Category

1 W 

2 W 

Part III Summary of Reported Vehicles

a Enter the number of taxable vehicles from Form 2290, page 2, column 3, Totals . . . . . . . . . . . a 

b Enter the total number of taxable vehicles on which the tax is suspended from Form 2290, page 2, column 3 (category W) b 

For Privacy Act and Paperwork Reduction Act Notice, see page 9 of the instructions. Cat. No. 11250O Schedule 1 (Form 2290) (Rev. 7-2009)
Schedule 1 (Form 2290) (Rev. 7-2009) Page 2 

Consent to Disclosure of Tax Information

For the period July 1, 2009, through June 30, 2010

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 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 submitted to the IRS within 60 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. 7-2009)
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 line 6 of Form 2290 using EFTPS or electronic 

funds withdrawal (direct debit).

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 (EIN)” 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 line 6 of Form 2290.

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

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

2290.

● Enclose your check or money order made payable to 

the “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. See Where to file on page 3 of the 

instructions for Form 2290.

¶ Detach here ¶

Form

2290-V

(Rev. July 2009)

Department of the Treasury 

Internal Revenue Service 

Payment Voucher

For the period July 1, 2009, through June 30, 2010 

See How To Make Your Payment on page 7 of the instructions. 

© 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.

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 instructions.)