Include the suite, room, or other unit number after the street address.
If the post office does not deliver mail to the street address and you have a P.O. box, show the box number instead of the
street address.
Enter the information in the following order: city, province or state, and country. Follow the country's practice for entering
the postal code. Do not abbreviate the country's name.
Enter the name, daytime telephone number, fax number, and email address for the person who should be contacted to discuss
this information return.
Employer Identification Number (EIN)
Enter your EIN. If you do not have an EIN, use Form SS-4, Application for Employer Identification Number, to apply for one.
You can get this form at Social Security Administration offices or by calling 1-800-TAX-FORM (1-800-829-3676). You can apply
for an EIN online or by telephone, fax, or mail. See the Instructions for Form SS-4 for more information. If you have applied
for an EIN but you do not have your EIN by the time you must file your information return, enter “Applied for” in any space where your EIN must be entered.
Form 637 Registration Number
Enter the assigned IRS number. Regulations sections 48.4101-1(c)(1)(iii)(iv)(vi) and (vii) require pipeline operators, position
holders, terminal operators, and vessel operators to be registered by the IRS. If you do not have a registration number, use
Form 637, Application for Registration (For Certain Excise Tax Activities). Form 637 has information on how to apply for a
registration number.
Carrier and Consignor Names and EINs
EINs are used to associate and verify transactions you report to the IRS. Therefore, it is important that you furnish correct
names and EINs for carriers and consignors on the forms sent to the IRS.
You may use Form W-9, Request for Taxpayer Identification Number and Certification, or your own form, to request an EIN from
a carrier or a consignor. You may be subject to a penalty for an incorrect or missing EIN on an information return. See Penalty on page 1. You are required to maintain the confidentiality of information obtained on a Form W-9 relating to the taxpayer's
identity and you may use such information only to comply with filing these information returns.
Note.
Foreign persons may use the appropriate Form W-8. See the Instructions for the Requester of Forms W-8BEN, W-8ECI, W-8EXP, and W-8IMY.
Approved terminal.
A terminal (see
Terminal definition below) that is operated by a taxable fuel registrant that is a terminal operator.
Consignor.
The person that hires the carrier to transport liquid product.
Exports.
Reportable products leaving the US. Only the mode codes listed are allowed. For example, EB, ES, or EP (for pipeline).
Reporting the destination country is optional. See
Table 3. Abbreviations on page 6.
Facility control number (FCN).
A number that designates a storage location within the motor fuel, renewable fuel production, or the bulk transfer/terminal
system. Facilities include approved terminals (TCN), biodiesel production facilities (BCN), or ethanol production facilities
(ECN). The list of facilities can be found at
www.irs.gov/excise.
Gross gallons.
The total product measured in U.S. gallons without temperature or barometric adjustments.
Imports.
Reportable liquid products entered into the US by an importer of record/enterer. Only the following mode codes listed
are allowed. For example, IB, IS, or IP (for pipeline). Reporting the country of origin is optional. See
Table 3. Abbreviations on page 6.
Note. An import is only reported when the product is first entered into the US. Fuel is no longer characterized as an import after
the fuel product enters the US.
Liquid product.
Any liquid that is transported into storage at any facility. Liquid products are specifically identified and reported
separately by their product codes listed in
Table 2. Product Codes on page 5. Product code 122 is used for any unlisted liquid that is used for blending into other products. Product code 092
is used for other unlisted liquids.
Mode codes.
The table below lists the mode codes.
Table 1. Mode codes
| B barge
|
IB import by barge
|
EB export by barge
|
| S ship (Great Lake or ocean)
|
IS import by ship
|
ES export by ship
|
| PL pipeline
|
IP import by pipeline
|
EP export by pipeline
|
Net gallons.
Liquid product measured in U.S. gallons corrected to a temperature of 60° Fahrenheit or 15° Celsius and to a pressure
of 14.7 pounds per square inch (psi).
Terminal.
A taxable fuel storage and distribution facility that is supplied by pipeline or vessel and from which liquid products,
such as taxable fuel, may be removed at a rack. However, the term does not include any facility at which gasoline blendstocks
are used in the manufacture of products other than finished gasoline and from which no gasoline is removed. Also, the term
does not include any facility where finished gasoline, undyed diesel fuel, or undyed kerosene is stored if the facility is
operated by a taxable fuel registrant and all such taxable fuel stored at the facility has been previously taxed under section
4081 upon removal from a refinery or terminal.
Transport carriers (bulk).
Includes pipelines, barges, or ships transporting reportable liquid products to or from facilities. Bulk transport
carriers do not report crude oil movements.
Part II.Transactions for the Month
Part II is used to report a monthly summary of the receipts and disbursements from FCNs by product code.
Use only the product codes listed in Table 2. Product Codes on page 5.
Schedule A. Carrier Receipts From a Facility
Use this schedule to report each receipt of reportable liquid product at a facility. A separate Schedule A must be used for
each facility and product code.
Enter the product code from Table 2 on page 5. Product code 122 (blending components, other) includes gasoline blendstocks as defined in Regulations section
48.4081-1(c)(3)(i) but not listed in the product code table.
Column (a).
Enter the EIN of the company hiring the carrier.
Column (b).
Enter the name of the company hiring the carrier.
Column (c).
Enter the code from Table 1 on page 3.
Column (d).
If the mode code in column (c) is either a barge (B, IB, or EB) or a ship (S, IS, or ES), enter the vessel official
number.
Column (e).
Enter the date from the document in column (e) (mmddyyyy).
Column (f).
Enter the identifying number from the document provided by the terminal operator to the carrier that reflects the
details of the transaction. This could be a bill of lading, manifest, inspection report, or other shipping document. Both
the carrier and terminal operator must report the same document number.
Column (g).
Enter the actual net gallons received from the facility.
Schedule B. Carrier Deliveries to a Facility
Use this schedule to report each delivery of reportable liquid products to an FCN. A separate Schedule B must be used for
each FCN and each product code.
Facility Name/Number (FCN).
Enter the facility name and FCN.
Enter the product code from Table 2. Product Codes on page 5.
Column (a).
Enter the EIN of the company hiring the carrier.
Column (b).
Enter the name of the company hiring the carrier.
Column (c).
Enter the mode code from
Table 1. Mode codes on page 3.
Column (d).
If the mode code in column (c) is either a barge (B, IB, or EB) or a ship (S, IS, or ES), enter the vessel official
number.
Column (e).
Enter the date from the document in column (f) (mmddyyyy).
Column (f).
Enter the identifying number from the document provided by the carrier to the terminal operator when the product is
delivered to the facility that reflects the details of the transaction. This could be the facility receipts document, pipeline
ticket number, barge ticket number, inspection report, etc. Both the carrier and terminal operator must report the same document
number.
Column (g).
Enter the actual net gallons delivered to the terminal.