PDF document

- 1 -

 Form REF-1000                                   Indiana Department of Revenue              Mailing/Contact Information:
 State Form 50854                                                                           Indiana Department of Revenue
 (R16 / 6-23)                      Claim for Fuel Tax Refund                                P.O. Box 1971
                                                                                            Indianapolis, IN 46206-1971
                                                                                            317-615-2630
                                                                                            fetax@dor.in.gov

 Section A: Information
Individual or Business Name                                        Social Security Number or Federal Identification Number

Street Address                                                     Indiana Taxpayer Identification Number

City, State and ZIP Code                                           Refund Period

Telephone Number                                                   Email Address

Use of Fuel (Only Check One):
□ A – Agriculture                 □ F – Maintenance                □ K – Refrigeration   □ N – Federal
□ B – Aviation                    □ G – Manufacturing              □ L – Taxicabs        □ O – Denaturing
□ C – Building/Construction       □ H – Marine                     □ M – Other (Specify) □ P – Compressed Natural Gas
□ D – Export                      □ I – Mining                          _________________
□ E – Local Transit Systems       □ J – Railroad 

Section B: Refund Computation
                                                                                Gasoline                 Special Fuel
                                                                        (Use Whole Gallons)              (Use Whole Gallons)
1.  Gallons Used for Exempt Purposes (Section C, Line 11)
2. Proportional Gallons Eligible for Fuel Tax Refund (Section D, Line 6)
3.  Total Gallons Eligible for Fuel Tax Refund (Line 1 plus Line 2)
4. Fuel Tax Rate (See table below)
5.  Fuel Tax Refund (Line 3 multiplied by Line 4)
6.  Oil Inspection Fee Refund (Line 3 multiplied by .01)
7.  Collection Allowance Adjustment
8.  Total Fuel Tax Refund (Line 5 plus Line 6 minus Line 7)
9.  Total Refund Claimed (Line 8 Gasoline plus Line 8 Special Fuel)

                                                        Tax Rate Table
 Refund Tax Period                               Gasoline Tax Rate                       Special Fuel Tax Rate
 July 1, 2019 - June 30, 2020                              $0.30                                         $0.49
 July 1, 2020 - June 30, 2021                              $0.31                                         $0.51
 July 1, 2021 - June 30, 2022                              $0.32                                         $0.53
 July 1, 2022 - June 30, 2023                              $0.33                                         $0.55
 Periods on or after July 1, 2023                          $0.34                                         $0.57

- 2 -

Enlarge image

Section C: Exempt Use Details
1. Vehicle or 2. Make and 3. Licensed with 4. Description of Use 5. Exempt Gallons Used (Whole Gallons)
Equipment Type Model the BMV Gasoline Special Fuel

□ Yes □ No

□ Yes □ No
6. Subtotal
7. Tax-Paid Gallons Used to Denature Alcohol
8. Tax-Paid Gallons Exported to Another State
9. Tax-Paid Gallons Used in a Motorboat on Lake Michigan or the Ohio River
10. Tax-Paid Gallons Sold to the U.S. Government
11. Tax-Paid Special Fuel Gallons Used When Converting to a
Compressed Natural Gas Product
12. Total to Report in Section B, Line 1 (Add Lines 6 through 11)

Section D: Proportional Use Exemption Details
1. Vehicle Type 2. Weight of Vehicle 3. Gallons Used 4. Exempt 5. Whole Gallons Eligible for Refund
(Whole Gallons) Percentage (Column 3 multiplied by Column 4)
(See chart
Gasoline Special Fuel below) Gasoline Special Fuel
□ 26,000 lbs or less
□ Over 26,000 lbs
□ 26,000 lbs or less
□ Over 26,000 lbs
□ 26,000 lbs or less
□ Over 26,000 lbs
□ 26,000 lbs or less
□ Over 26,000 lbs
□ 26,000 lbs or less
□ Over 26,000 lbs
□ 26,000 lbs or less
□ Over 26,000 lbs
6. Total to Report in Section B, Line 2

- 3 -

Enlarge image

Bookmobile                     25% Line Truck/Aerial Lift Truck        20% Semi-Wrecker                       35%
Boom Truck/Block Boom          20% Milk Tank Truck                     30% Service Truck with Jack Hammer     15%
Bulk Feed Truck                15% Mobile Crane                        42% Service Truck with Pneumatic Drill 15%
Car Carrier with Hydraulic     10% Pneumatic Tank Truck                15% Sewer Cleaning Truck/Sewer Jet/    35%
Winch                                                                      Sewer Vactor
Carpet Cleaning Van            15% Ready Mix Concrete Truck            30% Snow Plow Truck                    10%
Digger-Derrick Truck           20% Refrigeration Truck                 15% Spray Truck                        15%
Dump Truck                     23% Salt Spreader/Dump Truck with Spreader 15% Super Sucker Truck              90%
Fire Truck                     48% Sanitation Dump Trailer             15% Sweeper Truck                      20%
Hot Asphalt Distribution Truck 10% Sanitation Truck                    41% Tank Transport                     15%
Leaf Truck                     20% Seeder Truck                        15% Tank Truck                         24%
Lime Spreader Truck            15% Semi-Tractor and Dump Trailer Combo 15% Truck with Power Take-Off          20%
                                                                           Hydraulic Winch
                                                                           Wrecker                            10%

This claim must be signed by the taxpayer or by an authorized agent. If signed by an authorized agent, a properly completed power of 
attorney form must be attached.

I hereby certify that the amount claimed is legally due, after allowing all just credits, and that no part of the same has been paid. I further  
understand that this refund may be applied to any outstanding liability which I currently have. Under penalties of perjury, I declare that I 
have examined this form and to the best of my knowledge and belief it is true, correct, and complete.

Printed Name: _____________________________   Signature: ____________________________   Date:____________________

Preparer Printed Name: ______________________   Signature: ____________________________   Date:____________________

Phone Number: ____________________________   Email Address:  ______________________________

For Department Only

Tax Analyst: _______________________________   Date: __________________

Supervisor:  _______________________________   Date: __________________

- 4 -

Enlarge image

Instructions for Completing the Claim for Fuel Tax Refund
What is the REF-1000? What type of documentation is proof that tax was paid?
The REF-1000 form is used to file for a refund of un-dyed special • Invoices/Receipts/Reports that include:
fuel excise tax, gasoline excise tax, and oil inspection fee. o Name and address of seller
o Name of purchaser
Who should file? o Number of gallons purchased
Anyone who purchased un-dyed special fuel or gasoline, paid the Date purchased
Indiana excise tax, and oil inspection fee, and later used it for an o
exempt purpose. If the fuel is being used in a vehicle, the declared o Type of fuel purchased
gross weight must be 26,000 pounds or less. o Amount of tax paid
• MF-360 (Consolidated Gasoline Monthly Tax Return)
Indiana Motor Carriers and IFTA Carriers should use Form MCS- • SF-900 (Consolidated Special Fuel Monthly Tax Return)
1789 to file a claim for refund. • Tax returns for other states showing gallons exported
from Indiana
How do I file a Claim for Fuel Tax Refund (Form REF-1000)?
• File electronically via INTIME, DOR’s e-services portal, Questions
at intime.dor.in.gov. If you need further assistance, you can contact us at
• Mail the completed claim and supporting documentation 317-615-2630 or fetax@dor.in.gov.
to the address listed on the front of the form.
• Email the completed claim and supporting Section A: Information
documentation to fetax@dor.in.gov.
Name – Enter the name of the individual or entity making the
What are some examples of exempt usage? claim.
• Operating agricultural equipment (tractors, combines,
harvesters). Vehicles registered by the Indiana Bureau of Address – Enter the location address.
Motor Vehicles are not eligible for refund.
• Operating off-highway equipment (cranes, forklifts, Telephone Number – Enter the phone number for the responsible
sawmills, stationary engines, in-plant industrial use). point of contact for completing the claim.
• Using fuel for non-highway purposes (planes, trains,
home heating). Social Security Number (SSN)/Federal Employer Identification
• Operating as a common carrier of passengers, including Number (FEIN) – If the claim is for an individual, enter the SSN. If
a taxicab as defined in Indiana Code 6-6-1.1-103(l). the claim is for an entity, enter the FEIN.
• Operating a for-hire bus as defined in Indiana Code 9-13-
2-66.7. Indiana Taxpayer Identification Number (TID) – Enter the
• Operating a public transportation vehicle or public transit 10-digit TID. If you do not know the TID, leave this space blank.
system.
• Operating a vehicle using mounted equipment with Refund Period – Enter the beginning and ending dates of the
a common fuel supply reservoir may qualify for a period being claimed.
proportional use exemption.
• Purchasing Indiana tax-paid fuel for export. Email Address – Enter the email address of the person
• Selling Indiana tax-paid fuel to the U.S. Government. responsible for completing the claim. If you do not have an email
• Using Indiana tax-paid fuel to denature alcohol. address, leave this space blank.
• Operating refrigeration units mounted on motor vehicles
with a separate fuel tank exclusively for cooling. Use of Fuel – Mark the appropriate box to indicate how the fuel
• Converting special fuel into a compressed natural gas was used.
product. This is the difference between the amount of
special fuel purchased by a compressed natural gas Section B: Refund Computation
product fuel station and the amount of compressed Separate refund forms must be filed for different gasoline
natural gas product produced and sold by the fuel and special fuel tax rates. Refer to the Tax Rate Table.
station.
Example: Fuel is purchased for a non-taxable use for the period
When should I file? April 1, 2022 through September 30, 2022. Two refund claim
A claim for refund can be filed on a monthly, quarterly, semi- forms must be filed.
annual or annual basis.
1 stclaim – April 1, 2022 through June 30, 2022
Special fuel claims must be filed within three years of the date of
purchase. For example, you purchased special fuel on July 20, 2 ndclaim – July 1, 2022 through September 30, 2022
2020. You have until July 20, 2023 to file a claim for refund.
Line 1 – Enter the amount from Section C, Line 11.
Gasoline claims must be filed by April 15 of the year succeeding
three years from the date of purchase. For example, you purchased Line 2 – Enter the amount from Section D, Line 6.
gasoline on July 20, 2020. You have until April 15, 2024 to file a
claim for refund. Line 3 –Line 1 plus Line 2.
Compressed natural gas claims must be filed on a quarterly basis Line 4 – Enter the appropriate rate(s) from the table(s).
no later than the end of the third month following the end of the
calendar quarter. Line 5 – Multiply Line 3 by Line 4.

- 5 -

Enlarge image

Line 6 – Multiply Line 3 by .01 (Special Fuel Only). Section D: Proportional Use Exemption Details
Proportional use exemptions apply to fuel consumed by
Line 7 – Enter the sum of all collection allowance credits from commercial equipment being used on a vehicle that shares a
your invoices (Special Fuel Only). common fuel reservoir. Each vehicle type must be listed on a
separate line. If you operate a type of vehicle that is not listed,
Line 8 – Line 5 plus Line 6 minus Line 7. please contact our office at 317-615-2630 or fetax@dor.in.gov.
Line 9 – Line 8 gasoline plus Line 8 special fuel. Column 1 – Enter the type of vehicle from the list.
Section C: Exempt Use Details Column 2 – Mark the applicable box.
This section must be completed if you used gasoline and/or
special fuel for an exempt purpose. Column 3 – Enter the whole gallons consumed.
Complete Columns 1 through 5 if the fuel was used for an exempt Column 4 – Enter the applicable exemption percentage from the
reason other than the reasons listed in Lines 7 through 10. chart.
Column 1 – Enter the type of vehicle or equipment. Column 5 – Multiply Column 3 by Column 4.
Column 2 – Enter the make and model. Line 6 – Enter the total(s) from Column 5.
Column 3 - Indicate if the vehicle is licensed with the Indiana
Bureau of Motor Vehicles.
Column 4 – Describe how the fuel was used in an exempt
manner (e.g., plowing fields, building construction, home heating,
operating a taxicab).
Column 5 – Enter the whole gallons consumed in an exempt
manner.
Line 6 – Enter the total from Column 5.
Line 7 – Enter the number of Indiana tax-paid gallons used to
denature alcohol (Gasoline Only).
Line 8 – Enter the number of Indiana tax-paid gallons exported
from Indiana to another state.
Line 9 – Enter the number of Indiana tax-paid gallons used in a
motorboat on Lake Michigan or the Ohio River (Gasoline Only).
Line 10 – Enter the number of Indiana tax-paid gallons sold to the
U.S. Government.
Line 11 – Enter the difference between the amount of special
fuel purchased by a compressed natural gas product fuel station
and the amount of compressed natural gas product produced
and sold. For station retailers, unless DOR has approved an
alternative conversion factor, the fueling station operator should
report compressed natural gas GGE units based on each 5.66 lb.,
or 123.57 cu. ft. of natural gas dispensed.
Line 12 – Add lines 6 through 11.

PDF file checksum: 2476840266

(Plugin #1/9.12/13.0)