Form 720

(Rev. April 2016)

Department of the Treasury 

Internal Revenue Service 

Quarterly Federal Excise Tax Return

▶ See the Instructions for Form 720.

▶ Information about Form 720 and its separate instructions is at www.irs.gov/form720.

OMB No. 1545-0023

Check here if: 

Final return 

Address change 

Name Quarter ending 

Number, street, and room or suite no. 

(If you have a P.O. box, see the instructions.) 

Employer identification number 

City or town, state or province, country, and ZIP or foreign postal code

FOR IRS USE ONLY 

T 

FF 

FD 

FP 

I 

T 

Part I 

IRS No. Environmental Taxes (attach Form 6627) Tax IRS No. 

18 Domestic petroleum oil spill tax 18 

21 Imported petroleum products oil spill tax 21 

98 Ozone-depleting chemicals (ODCs) 98 

19 ODC tax on imported products 19 

 Communications and Air Transportation Taxes (see instructions) Tax 

22 Local telephone service and teletypewriter exchange service 22 

26 Transportation of persons by air 26 

28 Transportation of property by air 28 

27 Use of international air travel facilities 27 

 Fuel Taxes Number of gallons Rate Tax 

 (a) Diesel, tax on removal at terminal rack 

60 (b) Diesel, tax on taxable events other than removal at terminal rack 

 (c) Diesel, tax on sale or removal of biodiesel mixture 

(not at terminal rack)

60 

104 Diesel-water fuel emulsion 104 

105 Dyed diesel, LUST tax 105 

107 Dyed kerosene, LUST tax 107 

119 LUST tax, other exempt removals (see instructions) 119 

35 (a) Kerosene, tax on removal at terminal rack (see instructions) 

 (b) Kerosene, tax on taxable events other than removal at terminal rack 35 

69 Kerosene for use in aviation (see instructions) 69 

77 Kerosene for use in commercial aviation (other than foreign trade) 77 

111 Kerosene for use in aviation, LUST tax on nontaxable uses 111 

79 Other fuels (see instructions) 79 

 (a) Gasoline, tax on removal at terminal rack 

62 (b) Gasoline, tax on taxable events other than removal at terminal rack 62 

13 Any liquid fuel used in a fractional ownership program aircraft 13

14 Aviation gasoline 14 

112 Liquefied petroleum gas (LPG) (see instructions) 112 

118 “P Series” fuels 118 

120 Compressed natural gas (CNG) (see instructions) 120 

121 Liquefied hydrogen 121 

122 Fischer-Tropsch process liquid fuel from coal (including peat) 122 

123 Liquid fuel derived from biomass 123 

124 Liquefied natural gas (LNG) (see instructions) 124 

}

}

}

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 10175Y Form 720 (Rev. 4-2016) 
Form 720 (Rev. 4-2016) Page 2 

IRS No. Rate Tax IRS No. 

33 Retail Tax—Truck, trailer, and semitrailer chassis and bodies, and tractor 33

 Ship Passenger Tax Number of persons Rate Tax 

29 Transportation by water 29 

 Other Excise Tax Amount of obligations Rate Tax 

31 Obligations not in registered form 31 

 Foreign Insurance Taxes—Policies issued by foreign insurers Premiums paid Rate Tax IRS No. 

 Casualty insurance and indemnity bonds 

30 Life insurance, sickness and accident policies, and annuity 

contracts 30 

 Reinsurance } 

Manufacturers Taxes Number of tons Sales price 

36 Coal—Underground mined 36 

37 37 

38 Coal—Surface mined 38

39 39 

Number of tires Tax IRS No. 

108 Taxable tires other than bias ply or super single tires 108 

109 Taxable bias ply or super single tires (other than super single tires designed for steering) 109 

113 Taxable tires, super single tires designed for steering 113 

40 Gas guzzler tax. Attach Form 6197. Check if one-time filing . . . . . . . . . . . . 40 

97 Vaccines (see instructions) 97 

136 Reserved

Sales price

2.3% of sales price 136

1 Total. Add all amounts in Part I. Complete Schedule A unless one-time filing ▶ $ 

Part II 

IRS No. 

Patient‐Centered Outcomes Research Fee (see 

instructions)

(a) Avg. number 

of lives covered 

(see inst.)

(b) Rate for 

avg. 

covered life

(c) Fee (see

instructions) Tax IRS No. 

133

Specified health insurance policies

133

(a) With a policy year ending before October 1, 2015 

(b) With a policy year ending on or after October 1, 2015, 

and before October 1, 2016

 

Applicable self‐insured health plans

(c) With a plan year ending before October 1, 2015 

(d) With a plan year ending on or after October 1, 2015, and 

before October 1, 2016 } 

 Rate 

41 Sport fishing equipment (other than fishing rods and fishing poles) 41

110 Fishing rods and fishing poles (limits apply, see instructions) 110 

42 Electric outboard motors 42 

114 Fishing tackle boxes 114 

44 Bows, quivers, broadheads, and points 44 

106 Arrow shafts 106 

140 Indoor tanning services 140

 Number of gallons Rate Tax 

64 Inland waterways fuel use tax 64 

125 LUST tax on inland waterways fuel use (see instructions) 125 

51 Section 40 fuels (see instructions) 51 

117 Biodiesel sold as but not used as fuel 117 

20 Floor Stocks Tax—Ozone-depleting chemicals (floor stocks). Attach Form 6627. 20 

2 Total. Add all amounts in Part II ▶ $ 

Form 720 (Rev. 4-2016) 
Form 720 (Rev. 4-2016) Page 3 

Part III 

3 Total tax. Add Part I, line 1, and Part II, line 2 . . . . . . . . . . . . . . . . . ▶ 3 

4 Claims (see instructions; complete Schedule C) . . . . . . . ▶ 4 

5 Deposits made for the quarter . . . . ▶ 5 

Check here if you used the safe harbor rule to make your deposits. 

6 Overpayment from previous quarters . . ▶ 6 

7 Enter the amount from Form 720X included 

on line 6, if any . . . . . . . . . ▶ 7 

8 Add lines 5 and 6 . . . . . . . . . . . . . . . . . ▶ 8 

9 Add lines 4 and 8 . . . . . . . . . . . . . . . . . . . . . . . . . . ▶ 9 

10 Balance Due. If line 3 is greater than line 9, enter the difference. Pay the full amount with the return (see instructions) ▶ 10 

11 Overpayment. If line 9 is greater than line 3, enter the difference. Check if you want the 

overpayment: Applied to your next return, or Refunded to you. 11 

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 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 

▲

Title 

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 address ▶

Firm’s EIN ▶

Phone no.

Form 720 (Rev. 4-2016)
Form 720 (Rev. 4-2016) Page 4 

Schedule A Excise Tax Liability (see instructions) 

Note: You must complete Schedule A if you have a liability for any tax in Part I of Form 720. Do not complete Schedule A for 

Part II taxes or for a one-time filing of the gas guzzler tax. 

1 Regular method taxes 

(a) Record of Net 

Tax Liability 

Period 

 1st–15th day 16th–last day 

First month A B 

Second month C D 

Third month E F 

Special rule for September* . . . . . . . . . ▶ G 

(b) Net liability for regular method taxes. Add the amounts for each semimonthly period. 

2 Alternative method taxes (IRS Nos. 22, 26, 28, and 27) 

(a) Record of Taxes 

Considered as 

Collected

Period 

1st–15th day 16th–last day 

First month M N

Second month O P

Third month Q R

Special rule for September* . . . . . . . . . ▶ S

(b) Alternative method taxes. Add the amounts for each semimonthly period.

*Complete only as instructed (see instructions). 

Schedule T Two-Party Exchange Information Reporting (see instructions) 

Fuel Number of gallons 

Diesel fuel, gallons received in a two-party exchange within a terminal, included 

on IRS No. 60(a) on Form 720 

Diesel fuel, gallons delivered in a two-party exchange within a terminal 

Kerosene, gallons received in a two-party exchange within a terminal, included on IRS No. 35(a), 

69, 77, or 111 on Form 720 

Kerosene, gallons delivered in a two-party exchange within a terminal 

Gasoline, gallons received in a two-party exchange within a terminal, included on IRS No. 62(a) 

on Form 720 

Gasoline, gallons delivered in a two-party exchange within a terminal 

Aviation gasoline, gallons received in a two-party exchange within a terminal, 

included on IRS No. 14 on Form 720 

Aviation gasoline, gallons delivered in a two-party exchange within a terminal 

Form 720 (Rev. 4-2016) 
Form 720 (Rev. 4-2016) Page 5 

Schedule C Claims Month your income tax year ends ▶

• Complete Schedule C for claims only if you are reporting liability in Part I or II of Form 720. 

• Attach a statement explaining each claim as required. Include your name and EIN on the statement (see instructions). 

Caution: Claimant has the name and address of the person(s) who sold the fuel to the claimant, the dates of purchase, and if 

exported, the required proof of export. For claims on lines 1a and 2b (type of use 13 and 14), 3c, 4b, and 5, claimant has not waived 

the right to make the claim. 

1 Nontaxable Use of Gasoline Note: CRN is credit reference number. Period of claim ▶

Type of use Rate Gallons Amount of claim CRN 

a Gasoline (see Caution above line 1) $ 362 

b Exported (see Caution above line 1) 411 

2 Nontaxable Use of Aviation Gasoline Period of claim ▶

Type of use Rate Gallons Amount of claim CRN 

a Used in commercial aviation (other than foreign trade) $ 354 

b Other nontaxable use (see Caution above line 1) 324 

c Exported (see Caution above line 1) 412 

d LUST tax on aviation fuels used in foreign trade 433 

3 Nontaxable Use of Undyed Diesel Fuel Period of claim ▶

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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶

Type of use Rate Gallons Amount of claim CRN 

a Nontaxable use $ 360 

b Use in trains 353 

c Use in certain intercity and local buses (see Caution above line 1) 350 

d Use on a farm for farming purposes 360 

e Exported (see Caution above line 1) 413 

4 Nontaxable Use of Undyed Kerosene (Other Than Kerosene Used in Aviation) Period of claim ▶

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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶

Caution: Claims cannot be made on line 4 for kerosene sales from a blocked pump. Type of use Rate Gallons Amount of claim CRN 

a Nontaxable use $ 346 

b Use in certain intercity and local buses (see Caution above line 1) 347 

c Use on a farm for farming purposes 346 

d Exported (see Caution above line 1) 414 

e Nontaxable use taxed at $.044 377 

f Nontaxable use taxed at $.219 369 

5 Kerosene Used in Aviation (see Caution above line 1) Period of claim ▶

Type of use Rate Gallons Amount of claim CRN 

a Kerosene used in commercial aviation (other than foreign 

trade) taxed at $.244 $ 417 

b Kerosene used in commercial aviation (other than foreign 

trade) taxed at $.219 355 

c Nontaxable use (other than use by state or local 

government) taxed at $.244 346 

d Nontaxable use (other than use by state or local 

government) taxed at $.219 369 

e LUST tax on aviation fuels used in foreign trade 433 

Form 720 (Rev. 4-2016) 
Form 720 (Rev. 4-2016) Page 6 

6 Nontaxable Use of Alternative Fuel 

Caution: There is a reduced credit rate for use in certain intercity and local buses (type of use 5) (see instructions).

Type of use Rate Gallons, or gasoline 

or diesel gallon 

equivalents

Amount of claim CRN 

a Liquefied petroleum gas (LPG) (see instructions) $ 419 

b “P Series” fuels 420 

c Compressed natural gas (CNG) (see instructions) 421 

d Liquefied hydrogen 422 

e Fischer-Tropsch process liquid fuel from coal (including peat) 423 

f Liquid fuel derived from biomass 424 

g Liquefied natural gas (LNG) (see instructions) 425 

h Liquefied gas derived from biomass 435 

7 Sales by Registered Ultimate Vendors of Undyed Diesel Fuel Period of claim ▶

 Registration number ▶

Claimant certifies that it sold the diesel fuel at a tax-excluded price, repaid the amount of tax to the buyer, or has obtained 

written consent of the buyer to make the claim. 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶

Rate Gallons Amount of claim CRN 

a Use by a state or local government $ 360 

b Use in certain intercity and local buses 350 

8 Sales by Registered Ultimate Vendors of Undyed Kerosene 

(Other Than Kerosene For Use in Aviation) 

Period of claim ▶

 Registration number ▶

Claimant certifies that it sold the kerosene at a tax-excluded price, repaid the amount of tax to the buyer, or has obtained the 

written consent of the buyer to make the claim. 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶

Rate Gallons Amount of claim CRN 

a Use by a state or local government $ 346

b Sales from a blocked pump 

c Use in certain intercity and local buses 347 

9 Sales by Registered Ultimate Vendors of Kerosene For Use in Aviation Registration number ▶

Claimant sold the kerosene for use in aviation at a tax-excluded price and has not collected the amount of tax from the buyer, 

repaid the amount of tax to the buyer, or has obtained written consent of the buyer to make the claim. See the instructions for 

additional information to be submitted. 

Type of use Rate Gallons Amount of claim CRN 

a Use in commercial aviation (other than foreign trade) taxed at $.219 $ 355 

b Use in commercial aviation (other than foreign trade) taxed at $.244 417 

c Nonexempt use in noncommercial aviation 418 

d Other nontaxable uses taxed at $.244 346 

e Other nontaxable uses taxed at $.219 369 

f LUST tax on aviation fuels used in foreign trade 433 

10 Sales by Registered Ultimate Vendors of Gasoline Registration number ▶

Claimant sold the gasoline at a tax-excluded price and has not collected the amount of tax from the buyer, repaid the amount 

of tax to the buyer, or has obtained written consent of the buyer to take the claim; and obtained an unexpired certificate from 

the buyer and has no reason to believe any information in the certificate is false. See the instructions for additional information 

to be submitted. 

Rate Gallons Amount of claim CRN 

a Use by a nonprofit educational organization $ 362

b Use by a state or local government 

Form 720 (Rev. 4-2016) 
Form 720 (Rev. 4-2016) Page 7 

11 Sales by Registered Ultimate Vendors of Aviation Gasoline Registration number ▶

Claimant sold the aviation gasoline at a tax-excluded price and has not collected the amount of tax from the buyer, repaid the amount of 

tax to the buyer, or has obtained written consent of the buyer to take the claim; and obtained an unexpired certificate from the buyer 

and has no reason to believe any information in the certificate is false. See the instructions for additional information to be submitted. 

Rate Gallons Amount of claim CRN 

a Use by a nonprofit educational organization $ 324

b Use by a state or local government 

12 Biodiesel or Renewable Diesel Mixture Credit Period of claim ▶ Registration number ▶

Biodiesel mixtures. Claimant produced a mixture by mixing biodiesel with diesel fuel. The biodiesel used to produce the mixture met ASTM 

D6751 and met EPA's registration requirements for fuels and fuel additives. The mixture was sold by the claimant to any person for use as a 

fuel or was used as a fuel by the claimant. Claimant has attached the Certificate for Biodiesel and, if applicable, the Statement of Biodiesel 

Reseller. Renewable diesel mixtures. Claimant produced a mixture by mixing renewable diesel with liquid fuel (other than renewable diesel). 

The renewable diesel used to produce the renewable diesel mixture was derived from biomass, met EPA's registration requirements for fuels 

and fuel additives, and met ASTM D975, D396, or other equivalent standard approved by the IRS. The mixture was sold by the claimant to any 

person for use as a fuel or was used as a fuel by the claimant. Claimant has attached the Certificate for Biodiesel and, if applicable, Statement 

of Biodiesel Reseller, both of which have been edited as discussed in the instructions for line 13. See the instructions for line 13 for information 

about renewable diesel used in aviation. 

Rate Gal. of biodiesel or 

renewable diesel Amount of claim CRN 

a Biodiesel (other than agri-biodiesel) mixtures $ 388

b Agri-biodiesel mixtures 390

c Renewable diesel mixtures 307

13 Alternative Fuel Credit and Alternative Fuel Mixture Credit Registration number ▶

For the alternative fuel mixture credit, claimant produced a mixture by mixing taxable fuel with alternative fuel. Claimant certifies that it (a) 

produced the alternative fuel, or (b) has in its possession the name, address, and EIN of the person(s) that sold the alternative fuel to the 

claimant; the date of purchase; and an invoice or other documentation identifying the amount of the alternative fuel. The claimant also certifies 

that it made no other claim for the amount of the alternative fuel, or has repaid the amount to the government. The alternative fuel mixture was 

sold by the claimant to any person for use as a fuel or was used as a fuel by the claimant. 

Rate 

Gallons, or 

gasoline or diesel 

gallon equivalents 

(see instructions) 

Amount of claim CRN 

a Liquefied petroleum gas (LPG) $ 426

b "P Series" fuels 427

c Compressed natural gas (CNG) 428

d Liquefied hydrogen 429 

e Fischer-Tropsch process liquid fuel from coal (including peat) 430

f Liquid fuel derived from biomass 431

g Liquefied natural gas (LNG) 432

h Liquefied gas derived from biomass 436

i Compressed gas derived from biomass 437

14 Other claims. See the instructions. For lines 14b and 14c, see the Caution above line 1 on page 5. Amount of claim CRN 

a Section 4051(d) tire credit (tax on vehicle reported on IRS No. 33) $ 366 

b Exported dyed diesel fuel and exported gasoline blendstocks taxed at $.001 415 

c Exported dyed kerosene 416 

d Diesel-water fuel emulsion 

e Registered credit card issuers 

 Number of tires Amount of claim CRN 

f Taxable tires other than bias ply or super single tires $ 396 

g Taxable tires, bias ply or super single tires (other than super single tires designed for steering) 304 

h Taxable tires, super single tires designed for steering 305

i

j

k

15 Total claims. Add amounts on lines 1 through 14. Enter the result here and on Form 720, Part III, line 4. 15 

Form 720 (Rev. 4-2016) 
Form 720-V, 

Payment Voucher

Purpose of Form

Complete Form 720-V if you are making a payment by 

check or money order with Form 720, Quarterly 

Federal Excise Tax Return. We will use the completed 

voucher 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 this payment voucher to 

the return preparer.

Do not file Form 720-V if you are paying the balance 

due on line 10 of Form 720 using EFTPS.

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 faxing or mailing Form SS-4, Application for 

Employer Identification Number, to the IRS. However, if 

you are making a one-time filing, enter your social 

security number.

Box 2. Enter the amount paid from line 10 of Form 720.

Box 3. Darken the circle identifying the quarter for which 

the payment is made. Darken only one circle.

Box 4. Enter your name and address as shown on 

Form 720.

• Enclose your check or money order made payable to 

“United States Treasury.” Be sure to enter your 

EIN, (SSN for one-time filing), “Form 720,” and the tax 

period on your check or money order. Do not send cash. 

Do not staple this voucher or your payment to the return 

(or to each other).

• Detach the completed voucher and send it with your 

payment and Form 720. See Where To File in the 

Instructions for Form 720.

▼ Detach Here and Mail With Your Payment and Form 720. ▼ Form 720-V (2016) 

720-V

Department of the Treasury 

Internal Revenue Service

Payment Voucher

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

OMB No. 1545-0023

2016

1 Enter your employer identification 

number (EIN) (see instructions).

2

Enter the amount of your payment. ▶

Dollars Cents

3 Tax Period

1st 

Quarter

2nd 

Quarter

3rd 

Quarter

4th 

Quarter

4 Enter your business name (individual name if sole proprietor).

Enter your address.

City or town, state or province, country, and ZIP or foreign postal code.

Make your check or money order payable to “United States Treasury.”