Fillable Printable Fuel Tax Application
Fillable Printable Fuel Tax Application
Fuel Tax Application
Fuel Tax Application
Use this application to obtain a Fuel Tax license. You can also apply online through the Taxpayer Access Point (TAP) at:
https://wadolprft.gentax.com/TAP/_/
License types
Supplier License: Allows the purchase and storage of non-taxed fuel within the bulk transfer-terminal system. It also
allows for export and import of fuel.
Distributor License: Allows the tax-free purchase of fuel from a licensed supplier for immediate export to a destination
outside the state and the importation of fuel into the state by rail car or tanker truck. It also allows a tax-deferred purchase
of motor fuel or special fuel from a licensed supplier and the tax-exempt sale of fuel to qualifying entities.
Blender License: Allows the blending of taxed fuel with untaxed liquids to produce motor or special fuel, including
alternative fuels (biodiesel, ethanol, etc.) and for the production of alternative fuels outside the bulk transfer-terminal
system. Tax is imposed upon the volume of product not previously taxed.
Aircraft Fuel Distributor License: Allows the purchase of non-taxed aircraft fuel for resale.
Terminal License: Requires the reporting of fuel movement in IRS registered terminals within Washington State. A
separate license is required for each terminal location. However, you may apply for all locations using a single application.
Fuel Carrier License: For railroads operating in Washington.
Licensing requirements checklist
Use this checklist to complete your application for a fuel tax license. Do not include it with your application documents.
Prior to completing your fuel tax license application, register your business with Business Licensing Services at the
Department of Revenue (www.dor.wa.gov) to obtain a Unified Business Identifier (UBI). If registering as a corporation,
limited liability company, or partnership, contact the Secretary of State’s office (www.sos.wa.gov).
General Requirements:
Application
Each corporate officer or partner listed on the application (limit 3) must complete the employment or business history
section of this application.
Provide an original surety tax bond. Instructions for calculating the bond amount are included in the bond instructions.
An aircraft license requires a separate bond. Terminal operators and fuel carriers are not required to have bond
coverage.
Fuel Terminal operators provide:
Copy of the federal excise tax registration (IRS form 637) authorizing tax-free transactions in the bulk transfer-terminal
system.
Fuel suppliers provide:
Copy of the federal excise tax registration (IRS form 637) authorizing tax-free transactions in the bulk transfer-terminal
system.
Copies of licenses issued by jurisdictions (states and Canadian Provinces) from which fuel is imported from or to where
fuel is exported. If you plan to import from or export to a jurisdiction which does not require a license, you must provide
a written statement.
Fuel distributors provide:
Copies of licenses issued by jurisdictions (states and Canadian Provinces) from which fuel is imported from or to where
fuel is exported. If you plan to import from or export to a jurisdiction which does not require a license, you must provide
a written statement.
Fuel Blenders provide:
Copy of federal excise tax registration (IRS form 637) authorizing the production of biodiesel or ethanol and the
blending of these with petroleum products. If you are blending other products to make taxable fuel, contact us regarding
requirements.
For questions, contact us at (360) 664-1852.
WAC 308-77, 308-78. RCW 82.38, 82.42
FT-441-750 (R/7/17)WA Page 1 of 3
For office use
108-030-248-0001
Fuel Tax Application
Type of license (check all that apply)
Supplier
Distributor
Blender
Aircraft distributor
Terminal operator
Fuel carrier
Application type (check all that apply)
Original Reinstatement Address change Name change Ownership/Corporation change
Business structure (check one)
Sole proprietor Partnership Corporation LLC LLP
Business information
Legal name Trade name or DBA
Federal Employer Identification Number (FEIN) Unifed Business Identifier (UBI)
Mailing address, City, State, ZIP code (Area code) Telephone number
Applicant’s physical location address (no PO boxes), City, State, ZIP code
Contact person (Area code) Telephone number Email (Area code) Fax number
Name corporate officer or partner (limit 3 individuals) Title
1.
Name corporate officer or partner Title
2.
Name corporate officer or partner Title
3.
Have you ever held a fuel tax license in Washington State? .................................... Yes No
If yes, list business name on license
Terminal operators
List the IRS-registered terminals you operate in Washington State (attach additional pages if needed)
Terminal name Location
Terminal name Location
Suppliers, distributors, blender
List all jurisdictions with which you are exporting and importing fuel (attach additional pages if needed):
Jurisdiction License number
Import Export
Jurisdiction License number
Import Export
Jurisdiction License number
Import Export
Jurisdiction License number
Import Export
Jurisdiction License number
Import Export
FT-441-750 (R/7/17
)WA Page 2 of 3 (continued on next page)
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Bond requirements
The total amount of the bond, per license, is 3 times the estimated monthly fuel tax liability and cannot be less than $5,000
or more than $100,000.
For Motor and Special fuel:
Net taxable gallons x 3 x $0.494 (tax rate) = bond amount.
For Aircraft:
Net taxable gallons x 3 x $0.11 (tax rate) = bond amount.
History– Officer or Partner
Officer or owner name Date of birth
Street address
City State ZIP code
(Area code) Home telephone number Email address
From To Name of company Job title Immediate supervisor
Address (Street, City, State, ZIP code)
From To Name of company Job title Immediate supervisor
Address (Street, City, State, ZIP code)
Has this officer or partner been convicted of a crime or suffered a civil judgment directly related
to the distribution and sale of fuel within the past 10 years? ..................................... Yes No
Certification
I certify under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct.
Applicant name
Date and place Signature
Submit your report and supporting documents:
Online: Taxpayer Access Point (TAP) at https://wadolprft.gentax.com/TAP/_/
Mail: Department of Licensing
Fuel Tax Unit
PO Box 9228
Olympia, WA 98507-9228
Questions
Contact us at (360) 664-1852. For more information, visit our website at www.dol.wa.gov.
FT-441-750 (R/7/17)WA Page 3 of 3
