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Form 4136 Form Field Reference for TY2011

FORM 4136 Credit for Federal Tax Paid on Fuels

Field No.

Description

Line Ref.

 

0008

Statement in Lieu of Previously Field Certificate

 

0010

Off-Highway Business Use Gallons

1a(c)

0020

Use on Farm For Farming Purpose Gallons

1b(c)

0030

Nontaxable Use of Gasoline Type

1c(a)

0040

Nontaxable Use of Gasoline Gallons

1c(c)

0070

Nontaxable Use of Gasoline Cr. Amount

1c(d)

0080

Exported Nontaxable Use of Gasoline Gallons

1d(c)

0090

Exported Nontaxable Use of Gasoline Cr. Amount

1d(d)

0170

Commercial Aviation Gasoline Gallons

2a(c)

0180

Nontaxable Use of Commercial Aviation Gas Cr. Amt

2a(d)

0190

Nontaxable Use of Aviation Gasoline Type

2b(a)

0200

Nontaxable Use of Aviation Gasoline Gallons

2b(c)

0210

Nontaxable Use of Aviation Gas Cr Amt

2b(d)

0215

Exported Nontaxable Use of Aviation Gas Gallons

2c(c)

0220

Exported Nontaxable Use of Aviation Cr Amount

2c(d)

0225

Lust Tax on Aviation Fuel Gallons

2d(c)

0230

Lust Tax on Aviation Fuel Cr Amt

2d(d)

0240

Evidence of Dyed Diesel Fuel Explanation

3

0250

Evidence of Dyed Diesel Fuel Exception Box

3

0260

Nontaxable Use of Diesel Fuel Type

3a(a)

0270

Nontaxable Use of Diesel Fuel Gallons

3a(c)

0303

Diesel Fuel for Farming Purposes Gallons

3b(c)

0307

Diesel Fuel for Farming Purposes Cr. Amount

3b(d)

0310

Diesel Fuel Train Use Gallons

3c(c)

0320

Diesel Fuel Train Use Cr. Amt

3c(d)

0330

Diesel Fuel Certain Intercity Local Bus Use Gallon

3d(c)

0340

Diesel Fuel Certain Intercity & Bus Use Cr. Amt

3d(d)

0343

Diesel Fuel Exported Gallons

3e(c)

0347

Diesel Fuel Exported Cr. Amount

3e(d)

0350

Evidence of Dyed Kerosene Explanation

4

0360

Evidence of Dyed Kerosene Box

4

0370

Nontaxable Use of Kerosene Type

4a(a)

0380

Nontaxable Use of Kerosene Gallons

4a(c)

0399

Nontaxable Kerosene for Farming Purposes Gallons

4b(c)

0407

Kerosene Use Farm Cr. Amount

4b(d)

0409

Kerosene Use in Buses Gallons

4c(c)

0416

Kerosene Use in Buses Cr. Amount

4c(d)

0418

Nontaxable Use of Kerosene Exported Gallons

4d(c)

0420

Nontaxable Use of Kerosene Exported Cr. Amount

4d(d)

0425

Nontaxable Kerosene Aviation Rate 1 Type of Use

4e(a)

0430

Nontaxable Kerosene Aviation Rate 1 Gallons

4e(c)

0435

Nontaxable Kerosene Aviation Rate 1 Cr Amt

4e(d)

0440

Nontaxable Kerosene Aviation Rate 2 Type of Use

4f(a)

0445

Nontaxable Kerosene Aviation Rate 2 Gallons

4f(c)

0450

Nontaxable Kerosene Aviation Rate 2 Cr Amt

4f(d)

0550

Commercial Aviation Kerosene Gallons 1

5a(c)

0555

Commercial Aviation Kerosene Cr Amount 1

5a(d)

0560

Commercial Aviation Kerosene Gallons 2

5b(c)

0565

Commercial Aviation Kerosene Cr Amount 2

5b(d)

0570

Nontaxable Aviation Kerosene User Type 1

5c(a)

0575

Use of Nontaxable Aviation Kerosene Gal Type 1

5c(c)

0580

Use of Nontaxable Aviation Kerosene Amt Type 1

5c(d)

0585

Nontaxable Aviation Kerosene Use Type 2

5d(a)

0590

Use of Nontaxable Aviation Kerosene Gal Type 2

5d(c)

0595

Use of Nontaxable Aviation Kerosene Amt Type 2

5d(d)

0600

Lust Tax on Kerosene Gallons

5e(c)

0605

Lust Tax on Kerosene Cr Amt

5e(d)

0608

Undyed Diesel Fuel Registration No.

6

0610

Evidence of Dyed Diesel Fuel Explanation

6

0615

Evidence of Dyed Diesel Fuel Exception Box

6

0620

Use of Undyed Diesel by State or Local Gov Gallons

6a(c)

0625

Use of Undyed Diesel by State or Local Gov Cr. Amt

6a(d)

0630

Customer Information Attachment

6a

0635

Use Undyed Diesel Intercity Buses Gallons

6b(c)

0640

Use Undyed Diesel Intercity Buses Cr. Amount

6b(d)

0645

Undyed Kerosene Registration No.

7

0650

Evidence of Dyed Kerosene Explanation

7

0655

Evidence of Dyed Kerosene Exception Box

7

0660

Use of Undyed Kero by State or Local Gov Gallons

7a(c)

0665

Customer Information Attachment

7a

0670

Kerosene Sales from Blocked Pump Gallons

7b(c)

0680

Sales by Vendors of Undyed Kerosene Cr. Amount

7b(d)

0685

Undyed Kerosene Use in Certain Buses Gallons

7c(c)

0695

Undyed Kerosene Use in Certain Buses Cr. Amount

7c(d)

0705

Vendors of Kerosene for Use of Aviation Reg. No.

8

0715

Used in Commercial Aviation Gallons Type 1

8a(c)

0725

Used in Commercial Aviation Cr. Amount Type 1

8a(d)

0745

Other Use in Commercial Aviation Gallons Type 2

8b(c)

0750

Other Use in Commercial Aviation Cr. Amount Type 2

8b(d)

0755

Nonexempt Use Gallons

8c(c)

0757

Nonexempt Use Cr. Amount

8c(d)

0759

Other Nontaxable Use Type 1

8d(a)

0760

Other Nontaxable Use Gallons 1

8d(c)

0764

Other Nontaxable Use Cr. Amount 1

8d(d)

0768

Other Nontaxable Use Type 2

8e(a)

0770

Other Nontaxable Use Gallons 2

8e(c)

0775

Other Nontaxable Use Cr. Amount 2

8e(d)

0780

Lust Tax on Kerosene Foreign Trade Gallons

8f(c)

0785

Lust Tax on Kerosene Foreign Trade Cr Amt

8f(d)

0950

Alcohol Fuel Mixture Registration No.

9

0960

Alcohol Mixtures Ethanol Gallons

9a(c)

0970

Alcohol Mixtures Ethanol Cr. Amount

9a(d)

0980

Alcohol Mixtures Other Than Ethanol Gallons

9b(c)

0990

Alcohol Mixtures Other Than Ethanol Cr. Amount

9b(d)

3010

Biodiesel Mixture Registration No.

10

3020

Biodiesel Mix Gallons

10a(c)

3030

Biodiesel Mix Cr. Amount

10a(d)

3040

Agri-biodiesel Mix Gallons

10b(c)

3050

Agri-biodiesel Mix Cr. Amount

10b(d)

3060

Renewable Diesel Mix Gallons

10c(c)

3070

Renewable Diesel Mix Cr. Amount

10c(d)

3199

LPG Use Type Literal

11a(a)

3200

LPG Use Type

11a(a)

3210

LPG Gallons

11a(c)

3220

LPG Cr. Amount

11a(d)

3239

"P Series" Fuels Use Type Literal

11b(a)

3240

P Series Fuels Use Type

11b(a)

3260

P Series Fuels Gallons

11b(c)

3280

P Series Fuels Cr. Amount

11b(d)

3299

CNG Use Type Literal

11c(a)

3300

Compressed Natural Gas Use Type

11c(a)

3320

Compressed Natural Gas Gallons

11c(c)

3340

Compressed Natural Gas Cr. Amount

11c(d)

3359

Liquefied Hydrogen Use Type Literal

11d(a)

3360

Liquefied Hydrogen Use Type

11d(a)

3380

Liquefied Hydrogen Gallons

11d(c)

3400

Liquefied Hydrogen Cr. Amount

11d(d)

3419

Liquid Fuel from Coal Use Type Literal

11e(a)

3420

Liquid Fuel from Coal Use type

11e(a)

3440

Liquid Fuel from Coal Gallons

11e(c)

3460

Liquid Fuel from Coal Cr. Amount

11e(d)

3479

Liquid Hydrocarbons Use Type Literal

11f(a)

3480

Liquid Hydrocarbons Use Type

11f(a)

3500

Liquid Hydrocarbons Gallons

11f(c)

3520

Liquid Hydrocarbons Cr. Amount

11f(d)

3539

Liquefied Natural Gas Use Type Literal

11g(a)

3540

Liquefied Natural Gas Use Type

11g(a)

3560

Liquefied Natural Gas Gallons

11g(c)

3580

Liquefied Natural Gas Cr. Amount

11g(d)

3582

Liquefied Gas from Biomass Use Type Literal

11h(a)

3583

Liquefied Gas from Biomass Use Type

11h(a)

3585

Liquefied Gas Derived from Biomass Gas Gallons

11h(c)

3587

Liquefied Gas Derived from Biomass Credit Amount

11h(d)

3600

Alternative Fuel Cr. Reg. No.

12

3620

LPG Gallons

12a(c)

3640

LPG Cr. Amount

12a(d)

3660

P Series Fuels Gallons

12b(c)

3680

P Series Fuels Cr. Amount

12b(d)

3700

Compressed Natural Gas Gallons

12c(c)

3720

Compressed Natural Gas Cr. Amount

12c(d)

3740

Liquefied Hydrogen Gallons

12d(c)

3760

Liquefied Hydrogen Cr. Amount

12d(d)

3780

Liquid Fuel from Coal Gallons

12e(c)

3800

Liquid Fuel from Coal Cr. Amount

12e(d)

3820

Liquid Hydrocarbons Gallons

12f(c)

3840

Liquid Hydrocarbons Cr. Amount

12f(d)

3860

Liquefied Natural Gas Gallons

12g(c)

3880

Liquefied Natural Gas Cr. Amount

12g(d)

3881

Liquefied Gas Derived from Biomass Gallons

12h(c)

3883

Liquefied Gas Derived from Biomass Credit Amount

12h(d)

3885

Compressed Gas Derived from Biomass Gallons

12i(c)

3887

Compressed Gas Derived from Biomass Credit Amount

12i(d)

3900

Registered Credit Card Issuers Registration No.

13

3920

Diesel Fuel for State or Local Government Gallons

13a(c)

3940

Diesel Fuel for State or Local Government Cr. Amt

13a(d)

3960

Kerosene Fuel Sold for State or Local Gov Gallons

13b(c)

3980

Kerosene Fuel Sold for State or Local Gov Cr. Amt

13b(d)

4000

Kerosene Use in Aviation - State/Local Gov Gallons

13c(c)

4020

Kerosene Use in Aviation - State/Local Gov Cr. Amt

13c(d)

4119

Diesel-Water Fuel Emulsion Nontax. Use Literal

14a(a)

4120

Diesel-Water Fuel Emulsion Nontaxable Use Type

14a(a)

4140

Diesel-Water Fuel Emulsion Nontaxable Gallons

14a(c)

4160

Diesel-Water Fuel Emulsion Nontaxable Credit Amount

14a(d)

4180

Diesel-Water Exported Gallons

14b(c)

4200

Diesel-Water Exported Credit Amount

14b(d)

4220

Diesel-Water Fuel Emulsion Blending Reg. No.

15

4230

Customer Information Statement

15

4240

Diesel-Water Fuel Emulsion Blending Gallons

15a(c)

4260

Diesel-Water Fuel Emulsion Blending Credit Amount

15a(d)

4280

Exported Dyed Diesel Fuel Gallons

16a(c)

4300

Exported Dyed Diesel Fuel Credit Amount

16a(d)

4320

Exported Dyed Kerosene Gallons

16b(c)

4340

Exported Dyed Kerosene Credit Amount

16b(d)

4360

Total Income Tax Credit Amount

17

Page Last Reviewed or Updated: 2012-11-20