OMB No. 1545-1420
Registered Credit Card Issuers
(October 2006)
Department of the Treasury
Internal Revenue Service
Schedule 8
(Form 8849)
Name as shown on Form 8849
Use by a state or local government
Total refund (see instructions)
For Privacy Act and Paperwork Reduction Act Notice, see Form 8849 instructions.
Cat. No. 47991M
Schedule 8 (Form 8849) (10-2006)
C
C
©
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.
©
Sales of Undyed Kerosene (Other Than Kerosene For Use in Aviation)
1
Note. For lines 1 through 5, claimant (a) has not collected the amount of tax from the ultimate purchaser or has obtained the
written consent of the ultimate purchaser to make the claim, (b) has repaid or agreed to repay the amount of tax to the ultimate
vendor, has obtained the written consent of the ultimate vendor to make the claim, or has made arrangements that directly or
indirectly provide the ultimate vendor with repayment of the tax, and (c) has obtained the required certificate from the ultimate
purchaser and has no reason to believe any of the information in the certificate is false.
Use by a state or local government
Sales of Undyed Diesel Fuel
2
You must enter your registration number to make a
claim on Schedule 8.
(d)
CRN
From
©
To
©
(d)
CRN
360
346
(c) Amount of refund
(a) Rate
(b) Gallons
(c) Amount of refund
(a) Rate
(b) Gallons
$ .243
$ .243
Multiply col. (a) by col. (b)
Multiply col. (a) by col. (b)
$
EIN
$
$
Use by a nonprofit educational
organization
362
a
$
$
.183
Sales of Kerosene for Use in Aviation
3
Sales of Gasoline
4
Use by a nonprofit educational
organization
324
Use by a state or local government
a
b
$
$
.193
.193
Sales of Aviation Gasoline
5
Use by a state or local government
(kerosene taxed at $ .244)
346
a
$
$
.243
Use by a state or local government
b
.183
(d)
CRN
(c) Amount of refund
(a) Rate
(b) Gallons
Multiply col. (a) by col. (b)
(d)
CRN
(c) Amount of refund
(a) Rate
(b) Gallons
Multiply col. (a) by col. (b)
(d)
CRN
(c) Amount of refund
(a) Rate
(b) Gallons
Multiply col. (a) by col. (b)
Use by a state or local government
(kerosene taxed at $ .219)
b
369
.218
dd mmm yyyy
dd mmm yyyy
Page 2
Schedule 8 (Form 8849) (10-2006)
Instructions
You must enter your registration number. You are registered
if you received a letter of registration with a 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number from the IRS that has not been revoked or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. Use Form 637, Application for
Registration (For Certain Excise Tax Activities), to apply for
one.
Attach Schedule 8 to Form 8849. On the envelope write
“Registered Credit Card Issuer Claim” and mail to the IRS at
the address under Where To File in the Form 8849
instructions.
Lines 1 Through 5
Claim requirements. The following requirements must be
met.
1. The claim must be for taxable fuel sold during a period
that is at least 1 week.
Note. If the requirements above are not met for lines 1
through 3, see Annual Claims in the Form 8849 instructions.
2. The amount of the claim must be at least $200. To meet
this minimum, amounts from lines 1 through 5 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.
Add all amounts in column (c) and enter the result in the
total refund box at the top of the schedule.
New Schedule 8, Registered Credit Card Issuers, is used by
registered credit card issuers to make a claim for refund or
payment of tax paid on certain sales of taxable fuel (diesel
fuel, kerosene, and gasoline) to state and local governments
and certain sales of gasoline to nonprofit educational
organizations. The taxable fuel must have been purchased
with a credit card issued to the state or local government or
nonprofit educational organization by the credit card issuer
making the claim. These rules apply to taxable fuel sold after
December 31, 2005.
Required Certificate
Total Refund
Registration Number
How To File
Claims may be made for the fuels and uses as listed on
lines 1 through 5. To make a claim, the credit card issuer
must:
Purpose of Schedule
See Model Certificate R in Pub. 510, Excise Taxes for 2006.
1. Be registered by the IRS, and
2. Meet the conditions described in the note above line 1.
If 1 and 2 above are not met, or if the taxable fuel is
purchased without the use of a credit card issued by the
credit card issuer to a state or local government or nonprofit
educational organization, the credit card issuer cannot make
the claim.