3RD QUARTER 2018 (Round to Nearest Whole US Gallons and Miles Not Liters or Kilometers) (Enter Credits in Brackets) 3 4 5 6 7 8 9 10 11 1 2 TOTAL TAXABLE TAXABLE TAX-PAID NET TAXABLE TAX TAX (CREDIT) INTEREST TOTAL DUE JURIS- FUEL DICTION TYPE MILES MILES GALLONS GALLONS GALLONS RATE DUE Col. 7 x 8 DUE Col. 9 + 10 0.2925 MT D 0.6152 NB D 0.3510 NC D 0.2300 ND D 0.2800 NE D 0.2220 NH D 0.4420 NJ D 0.6152 NL D 0.2100 NM D 0.4406 NS D 0.2700 NV D 0.3915 NY D 0.2800 OH D 0.1900 OK D 0.4092 ON D OR D 0.0000 0.7410 PA D 0.5780 PE D 0.5780 QC D 0.3300 RI D 0.2000 SC D 0.2800 SD D 0.4292 SK D 0.2400 TN D 0.2000 TX D 0.2940 UT D 0.2020 VA D VA D SURCHARGE 0 0.0350 0.3100 VT D 0.4940 WA D 0.3570 WV D 0.2400 WY D 12. NON-IFTA Non-receipted gallons MILES 13. TOTALS Total Gallons D. Totals and Bulk Fuel Retain a copy of this report for your records. 1.1 Total From Column 11 $ I certify with my signature that the information and statements on this report are true and correct 1.2 Penalty (see instructions) $ to the best of my knowledge. X 1.3 Total Tax Due/Credit $ (Licensee or Authorized Agent Signature) (Date) 1.4 Do you have bulk fuel storage in Wisconsin? Yes No (Reporting Agent Title) (Area Code) Telephone Number Make Check Payable to: REGISTRATION FEE TRUST (If line 1.3 amount is $2.00 or less, no fee is due. We will not refund amounts that are $2.00 or less) For Instructions & tax rates see form MV2754 at: IF YOU OR YOUR REPRESENTATIVE HAVE ONLINE WISCRS ACCESS, YOU SHOULD FILE & PAY THIS RETURN ONLINE.
3RD QUARTER 2018 (Round to Nearest Whole US Gallons and Miles Not Liters or Kilometers) (Enter Credits in Brackets) 1 JURIS- DICTION 2 FUEL TYPE 3 TOTAL MILES 4 TAXABLE MILES 5 TAXABLE GALLONS 6 TAX-PAID GALLONS 7 NET TAXABLE GALLONS 8 TAX RATE 9 TAX (CREDIT) DUE Col. 7 x 8 10 INTEREST DUE 11 TOTAL DUE Col. 9 + 10 MT D 0.2925 NB D 0.6152 NC D 0.3510 ND D 0.2300 NE D 0.2800 NH D 0.2220 NJ D 0.4420 NL D 0.6152 NM D 0.2100 NS D 0.4406 NV D 0.2700 NY D 0.3915 OH D 0.2800 OK D 0.1900 ON D 0.4092 OR D 0.0000 PA D 0.7410 PE D 0.5780 QC D 0.5780 RI D 0.3300 SC D 0.2000 SD D 0.2800 SK D 0.4292 TN D 0.2400 TX D 0.2000 UT D 0.2940 VA D 0.2020 VA D SURCHARGE 0 0.0350 VT D 0.3100 WA D 0.4940 WV D 0.3570 WY D 0.2400 12. NON-IFTA MILES Non-receipted gallons 13. TOTALS Total Gallons Retain a copy of this report for your records. I certify with my signature that the information and statements on this report are true and correct to the best of my knowledge. D. Totals and Bulk Fuel 1.1 Total From Column 11 $ 1.2 Penalty (see instructions) $ X 1.3 Total Tax Due/Credit $ (Licensee or Authorized Agent Signature) (Date) 1.4 Do you have bulk fuel storage in Wisconsin? Yes No (Reporting Agent Title) (Area Code) Telephone Number Make Check Payable to: REGISTRATION FEE TRUST (If line 1.3 amount is $2.00 or less, no fee is due. We will not refund amounts that are $2.00 or less) For Instructions & tax rates see form MV2754 at: IF YOU OR YOUR REPRESENTATIVE HAVE ONLINE WISCRS ACCESS, YOU SHOULD FILE & PAY THIS RETURN ONLINE.
mv2755_3Q2018.docx