OMB No. 1545-1420 Sales by Registered Ultimate Vendors

of Undyed Diesel Fuel and Undyed Kerosene

(July 1999)

Schedule 2 Department of the Treasury—Internal Revenue Service

Name as shown on Form 8849

Use on a farm for farming purposes

Use by a state or local government

(Form 8849)

EIN or SSN

For Privacy Act and Paperwork Reduction Act Notice, see Form 8849 instructions. Cat. No. 27450U Schedule 2 (Form 8849) (7-99)

a

b

U V

© Attach to Form 8849. Do not file with any other schedule.

Period of claim Enter month, day, and year

in MMDDYYYY format. ©

Claimant’s Registration No. ©

U P

Sales by Registered Ultimate Vendors of Undyed Kerosene

1

Claimant certifies that the diesel fuel did not contain visible evidence of dye.

Exception. If any of the diesel fuel included in this claim did contain visible evidence of dye, attach a detailed explanation

and check here ©

Claimant sold the diesel fuel at a tax-excluded price, repaid the amount of tax to the buyer, or obtained written consent

of the buyer to make the claim; and obtained the required certificate from the buyer and has no reason to believe any

information in the certificate is false.

Use on a farm for farming purposes

Use by a state or local government

a

b

Sales by Registered Ultimate Vendors of Undyed Diesel Fuel

2

Claimant certifies that the kerosene did not contain visible evidence of dye.

Exception. If any of the kerosene included in this claim did contain visible evidence of dye, attach a detailed explanation

and check here ©

Claimant sold the kerosene at a tax-excluded price, repaid the amount of tax to the buyer, or obtained written consent

of the buyer to make the claim; and obtained the required certificate (for lines 2a and 2b) from the buyer and has no

reason to believe any information in the certificate is false.

Note: UV claimant must

complete line 3 on the back.

c Sales from a blocked pump

© (Complete only for line 2c.)

(d)

CRN

From To

(d)

CRN

303

303

(a) Rate (b) Gallons (c) Amount of refund

Enter whole gal. only.

In cents per gal.

Example: $.244

Do not use commas or $ signs.

Dollars Cents

(a) Rate (b) Gallons (c) Amount of refund

Enter whole gal. only.

In cents per gal.

Example: $.244

Do not use commas or $ signs.

Dollars Cents
Schedule 2 (Form 8849) (7-99)

Taxpayer Identification No. Name

Enter the information below for each farmer, custom harvester, or governmental unit to whom the fuel was sold. If more

space is needed, attach additional sheets. Check (K)erosene and/or (D)iesel, whichever applies, for each name listed.

3 Farmer and Government Unit Information

K D

Name as shown on Form 8849 EIN or SSN

Gallons

Page 2

Enter whole gal. only.

Schedule 2 (Form 8849) (7-99)
Schedule 2 (Form 8849) (7-99) Page 3

Instructions

Sales by Registered Ultimate Vendors of

Undyed Diesel Fuel and Undyed Kerosene

UV and UP registration numbers. You must enter your

registration number in the boxes provided. You are registered

if you received a UV (ultimate vendor of undyed diesel fuel

and undyed kerosene) or a UP (ultimate vendor of kerosene

sold from a blocked pump) registration number from the IRS

that has not been revoked or suspended. If you do not have

a registration number, you cannot make this claim. Get Form

637, Application for Registration (For Certain Excise Tax

Activities), to apply for one.

Amount of refund. Multiply the rate by the number of

gallons and enter the result in the boxes for column (c).

Required certificate. The certificate must contain all the

information as shown in the Model Certificate in Regulations

section 48.6427-9(e).

How to file. Attach Schedule 2 to Form 8849. On the

envelope write “Diesel Fuel/Kerosene Claim” and mail to the

IRS at the address under Where To File in the Form 8849

instructions.

Line 1—Sales By Ultimate Vendors of Undyed Diesel

Fuel

Claimant. The registered ultimate vendor of the diesel fuel is

the only person eligible to make this claim.

Allowable sales. The fuel must have been sold during the

Period of claim for:

● Use on a farm for farming purposes, or

● Use by a state or local government (including essential

government use by an Indian tribal government).

Claim requirements. The following requirements must be

met:

1. The claim must be for diesel fuel sold during a period

that is at least 1 week.

Note: If requirements 1–3 above are not met, see Annual

Claims in the Form 8849 instructions.

Information to be submitted. Complete Line 3, Farmer and

Government Unit Information, for each farmer, custom

harvester, or governmental unit to whom the diesel fuel was

sold and the number of gallons sold to each. If more space

is needed, attach additional sheets.

Lines 2a and 2b—Sales by Registered Ultimate

Vendors of Undyed Kerosene (Not From a Blocked

Pump)

Claimant. The registered ultimate vendor of the kerosene is

the only person eligible to make this claim.

Allowable sales. The fuel must have been sold during the

Period of claim for:

● Use on a farm for farming purposes, or

● Use by a state or local government (including essential

government use by an Indian tribal government).

Claim requirements. The following requirements must be

met:

1. The claim must be for kerosene sold during a period

that is at least 1 week.

2. The amount of the claim must be at least $100. To meet

this minimum, amounts from lines 2(a), (b), and (c) are

combined.

3. The claim must be filed by the last day of the first

quarter following the earliest quarter of the claimant’s income

tax year included in the claim. For example, a calendar-year

claimant’s claim for kerosene sold during September and

October must be filed by December 31.

Note: If requirements 1–3 above are not met, see Annual

Claims in the Form 8849 instructions.

Information to be submitted. Complete Line 3, Farmer and

Government Unit Information, for each farmer, custom

harvester, or governmental unit to whom the kerosene was

sold and the number of gallons sold to each.

Line 2c—Sales by Registered Ultimate Vendors of

Undyed Kerosene From a Blocked Pump

Claimant. The registered ultimate vendor of kerosene sold

from a blocked pump is the only person eligible to make this

claim.

Claim requirements. The following requirements must be

met:

1. The claim must be for kerosene sold from a blocked

pump during a period that is at least 1 week.

2. The amount of the claim must be at least $100. To meet

this minimum, amounts from lines 2(a), (b), and (c) are

combined.

3. The claim must be filed by the last day of the first

quarter following the earliest quarter of the claimant’s income

tax year included in the claim. For example, a calendar-year

claimant’s claim for kerosene sold during September and

October must be filed by December 31.

Note: If requirements 1–3 above are not met, see Annual

2. The amount of the claim must be at least $200. To meet Claims in the Form 8849 instructions.

this minimum, amounts from lines 1 and 2 may be combined.

3. The claim must be filed by the last day of the first

quarter following the earliest quarter of the claimant’s income

tax year included in the claim. For example, a calendar-year

claimant’s claim for diesel fuel sold during September and

October must be filed by December 31.

Period of claim. Enter the period of the claim using the

MMDDYYYY format. For example, the first quarter of 2000

for a calendar-year taxpayer would be from 01012000 to

03312000.

Purpose. A registered ultimate vendor of undyed diesel fuel

or undyed kerosene uses Schedule 2 to make a claim for

refund. The fuel must have been sold for use on a farm for

farming purposes or for the exclusive use by a state or local

government, or for kerosene from a blocked pump.

Gallons. Enter the amount to the nearest whole gallon. See

How To Round in the Form 8849 instructions.