4136

OMB No. 1545-0162

Credit for Federal Tax Paid on Fuels
Form

Department of the Treasury

© See the Instructions for Form 4136.
97
Attachment
Internal Revenue Service (99) © Attach this form to your income tax return. Sequence No. 23
Name (as shown on your income tax return) Taxpayer identification number

Caution: You cannot claim any amounts on Form 4136 that you claimed on Form 8849, Form 843, or Schedule C (Form 720).

1 Nontaxable Use of Gasoline

Type
Rate Gallons Amount of credit CRN
of use

%
a Off-highway business use $

301
b Use on a farm for farming purposes

c Other nontaxable use

2 Nontaxable Use of Gasohol

Type
Rate Gallons Amount of credit CRN
of use

%
a Gasohol containing at least 10% alcohol $
b Gasohol containing at least 7.7% alcohol but less than 312
10% alcohol
c Gasohol containing at least 5.7% alcohol but less than
7.7% alcohol

3 Nontaxable Use of Undyed Diesel Fuel (Lines 3a, b, and c)

Sales by Registered Ultimate Vendors of Undyed Diesel Fuel (Line 3d)

Claimant certifies that the diesel fuel did not contain visible evidence of dye.
If any of the diesel fuel included in this claim did contain visible evidence of dye, attach a detailed explanation and check here

%
Type Rate Gallons Amount of credit CRN
of use
Lines 3a, b, and c: Claimant has the name and address
of the person(s) who sold the diesel fuel to the claimant
and the date(s) of the purchase(s), and if exported, the
required proof of export.
a Heating oil $

b Off-highway business use

303
c Other nontaxable use (excluding use on a farm for
farming purposes)

d Claimant, a registered ultimate vendor, sold diesel fuel

for use by the buyer on a farm for farming purposes, or to
a state or local government for its exclusive use. Claimant
obtained the required certificate from the buyer and has
no reason to believe any of the information in the
certificate is false.

4 Nontaxable Use of Special Fuels

Type
Rate Gallons Amount of credit CRN
of use

%
a Special motor fuels (other than LPG, LNG, or fuels used in
intercity or local buses) $
b Liquefied petroleum gas (LPG) or liquefied natural gas (LNG)
304
c Special motor fuels used in intercity or local buses
d Compressed natural gas (credit rate per thousand cubic
feet) MCF
For Paperwork Reduction Act Notice, see the instructions. Cat. No. 12625R Form 4136 (1997)
Form 4136 (1997) Page 2
5 Nontaxable Use of Aviation Gasoline

Type
Rate Gallons Amount of credit CRN
of use

a Used in commercial aviation (other than foreign trade)

b Other nontaxable use

$

% 307

6 Nontaxable Use of Aviation Fuel (other than gasoline)

Type
Rate Gallons Amount of credit CRN
of use

b
Used in commercial aviation (other than foreign trade)

Other nontaxable use

$

% 310

7 Gasohol Blenders
Claimant bought gasoline taxed at the full rate ($.183/.184) and blended Rate Gallons of gasoline Amount of credit CRN
it with alcohol to make gasohol. The gasohol was used or sold for use in
a trade or business. For each batch of gasohol, claimant has the required
information relating to the purchase of the gasoline and alcohol used to
make the gasohol and to support the amount claimed.
Percentage of alcohol in the gasohol

%
a At least 10% alcohol $

302
b At least 7.7% alcohol but less than 10% alcohol

c At least 5.7% alcohol but less than 7.7% alcohol

8 Use of Undyed Diesel Fuel—Train and Intercity and Local Bus

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

Claimant has the name and address of the person(s) who sold
the diesel fuel to the claimant and the date(s) of the purchase(s).

a Diesel-powered trains

b Intercity and local buses

$
% 305

9 Total Income Tax Credit Claimed

Add lines 1 through 8. Enter here and on Form 1040, line 59 (also check box b on line 59); Form
1120, line 32g; Form 1120-A, line 28g; Form 1120S, line 23c; Form 1041, line 25g; or the proper
line of other returns © 9 $
Form 4136 (1997) Page 3

Table 1
Instructions for Form 4136
Item No. Type of Use
Changes To Note
1. The credit for diesel-powered highway vehicles 1 On a farm for farming purposes
does not apply after 1996. 2 For business other than in a highway vehicle registered
2. The credit rates have been deleted from Form (or required to be registered) for highway use
4136; instead, they are shown in the Rate Table for 3 Export
Fuel Tax Credits on this page. Enter the applicable 4 In a boat used in commercial fishing
rate(s) from the table in the Rate column on the form. 5 (Reserved)
3. The credit rates for aviation gasoline and aviation 6 In an intercity or local bus
fuel (other than gasoline) increased after March 6, 7 For diesel fuel and special motor fuels in a qualified local
1997. bus that
4. Generally, the credit rates for fuels increased by ● can seat at least 20 adults (excluding the driver) and
$.001 due to reinstatement of the Leaking ● is under contract by a state or local government to
Underground Storage Tank (LUST) tax after September furnish (for compensation) intracity passenger land
30, 1997. transportation that is available to the general public and
is scheduled and along regular routes
5. The credit rate for nontaxable use of liquefied
8 In a bus that transports students and school employees
petroleum gas and liquefied natural gas (line 4b)
decreased after September 30, 1997. See Table 2. 9 For diesel fuel other than as a fuel in the propulsion
engine of a diesel-powered highway vehicle or train
10 In foreign trade
Purpose of Form
11 In commercial aviation
Use Form 4136 to claim the credit for Federal excise 12 In certain aircraft
tax paid on fuels.
13 For aviation fuel used other than as a fuel in a propulsion
Partnerships. Partnerships cannot file this form. engine of an aircraft
Instead, they must include a statement on Schedule 14 For special fuels used other than as a fuel in a
K-1 (Form 1065), Partner’s Share of Income, Credits, propulsion engine of a motor vehicle or a motorboat
Deductions, etc., showing the allocation of the credits
to each partner specifying the number of gallons of
fuel allocated to each partner and the applicable tax Rate Table for Fuel Tax Credits
rates. The credit rates for Form 4136 are shown in the table
below.
Recordkeeping Enter the applicable rate(s) as shown in the following
You must keep records to support any credits claimed table in the Rate column on the form.
on this return for at least 3 years from the date the
return is due or filed, whichever is later.
Table 2
Reporting Fuel Tax Credit in Income Line Rates1
You must include in your gross income the amount of No. 1/1/97–3/6/97 3/7/97–9/30/97 After 9/30/97
the credit from line 9 if you took a deduction on your 1a–c .183 .183 .184
tax return for the taxes paid and that deduction 2a .129 .129 .13
reduced your tax liability. b .14142 .14142 .14242
c .15222 .15222 .15322
Additional Information
3a–d .243 .243 .244
● Form 8849, Claim for Refund of Excise Taxes, may
4a .183 .183 .184
be used to claim a periodic refund of excise taxes 3
instead of waiting to claim a credit on Form 4136. b .183 .183 .136/.119
2 3
c .109 .109 .109/.062 /.045
● Pub. 378, Fuel Tax Credits and Refunds, includes
definitions and additional excise tax rules. d .4854 MCF .4854 MCF .4854 MCF
5a — .15 .15
● Pub. 225, Farmer’s Tax Guide, also includes
information on credits for Federal tax paid on fuels. b .043 .193 .194
6a — .175 .175
Specific Instructions b .043 .218 .219
7a .03967 .03967 .03956
Type of Use Table b .02979 .02979 .0297
The following table lists the nontaxable uses for which c .02158 .02158 .02152
you may claim a credit for taxes paid on fuels. You 8a .1875 .1875 .1875
must enter the item number from the table in the b .169 .169 .17
applicable boxes in the Type of use column. 1
Rates are in cents per gallon, except as noted.
2
Rate for LPG.
3
Rate for LNG.
Form 4136 (1997) Page 4

Line 1 4d. Compressed natural gas. If you bought

1a. Off-highway business use. You must have used compressed natural gas at a price that included the
the gasoline for a business use other than in a highway tax, you must have used the compressed natural gas
vehicle registered (or required to be registered) for for uses 1, 2, 3, 4, 8, or 14 from Table 1. List the item
highway use. You cannot claim a credit for personal number on line 4d. The rate shown in the table is per
use of gasoline. thousand cubic feet (MCF).
1b. Use on a farm for farming purposes. You must Line 5
have used the gasoline on a farm for farming
5b. Other nontaxable uses. You must have used the
purposes. You cannot claim a credit for personal use
aviation gasoline for uses 1, 3, 10, or 12 from Table 1.
of gasoline.
List the item number on line 5b.
1c. Other nontaxable use. You must have used the
gasoline for uses 3, 4, 6, or 8 from Table 1. List the Line 6
item number on line 1c. To claim a credit for aviation
6b. Other nontaxable uses. You must have used the
gasoline, use line 5.
aviation fuel for uses 1, 10, 12, or 13 from Table 1. List
Line 2 the item number on line 6b.
You must have used the gasohol for uses 1, 2, 3, 4, 6, Line 7
or 8 from Table 1. List the item number on line 2. The
If you bought gasoline taxed at the full rate, have not
credit rate per gallon is based on the percentage of
claimed a refund, and used that gasoline to make
alcohol in the mixture.
gasohol, you may take a credit for each gallon of
Line 3 gasoline used to make gasohol. The credit rate per
gallon is based on the percentage of alcohol in the
3a. Heating oil. You must have used the undyed diesel mixture.
fuel as heating oil.
3b. Off-highway business use of undyed diesel fuel. Line 8
You must have used the diesel fuel for a business use You must have used the undyed diesel fuel for train or
other than in a highway vehicle registered (or required intercity or local bus use. For bus uses that qualify for
to be registered) for highway use. a full refund of the tax, use line 3c.
3c. Other nontaxable use. You must have used the
undyed diesel fuel for uses 3, 7, 8, or 9 from Table 1. Paperwork Reduction Act Notice. We ask for the
List the item number on line 3c. To claim a credit for information on this form to carry out the Internal
diesel fuel used in intercity or local buses or Revenue laws of the United States. You are required to
diesel-powered trains, use line 8. give us the information. We need it to ensure that you
Caution: You cannot claim a credit on line 3c for the are complying with these laws and to allow us to figure
tax paid on diesel fuel that you used on a far m for and collect the right amount of tax.
far ming purposes. You are not required to provide the information
3d. Sales by registered ultimate vendors. You must requested on a form that is subject to the Paperwork
attach the following information: Reduction Act unless the form displays a valid OMB
1. Your UV registration number issued to you by the control number. Books or records relating to a form or
IRS. its instructions must be retained as long as their
2. The name and TIN of each farmer, custom contents may become material in the administration of
harvester, or governmental unit who bought diesel fuel any Internal Revenue law. Generally, tax returns and
from you and the number of gallons that you sold to tax return information are confidential, as required by
each, and Code section 6103.
3. A statement that you have: The time needed to complete and file this form will
● Not included the amount of tax in the sales price vary depending on individual circumstances. The
and not collected the amount of tax from the buyer; or estimated average time is:
● Repaid the amount of the tax to the ultimate Recordkeeping 17 hr., 12 min.
purchaser of the fuel; or Learning about the
● Obtained the written consent from your buyer to law or the form 6 min.
take the credit. Preparing and sending
the form to the IRS 23 min.
Line 4 If you have comments concerning the accuracy of
4a and b. Special fuels. If you bought taxed special these time estimates or suggestions for making this
motor fuels, you must have used the special motor form simpler, we would be happy to hear from you.
fuels for uses 1, 2, 3, 4, 7, 8, or 14 from Table 1. List You can write to the Internal Revenue Service at the
the item number on lines 4a and b. address listed in the instructions of the tax return with
which this form is filed.