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  Form REF-1000                                 Indiana Department of Revenue                 Mailing/Contact Information:
  State Form 50854                                                                            Indiana Department of Revenue
  (R15 / 6-22)                      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                 □ E – Local Transit Systems           □ I – Mining       □ M – Other (Specify)
□ B – Aviation                    □ F – Maintenance                     □ J – Railroad     ______________________________
□ C – Building/Construction       □ G – Manufacturing                   □ K – Refrigeration
□ D – Export                      □ H – Marine                          □ L – Taxicabs

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, 2018 - June 30, 2019                            $0.29                                         $0.48
  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
  Periods on or after July 1, 2022                        $0.33                                         $0.55

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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. Total to Report in Section B, Line 1 (Add Lines 6 through 10)

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

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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: __________________

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Instructions for Completing the Claim for Fuel Tax Refund
What is the REF-1000? Questions
The REF-1000 form is used to file for a refund of un-dyed special If you need further assistance, you can contact us at
fuel excise tax, gasoline excise tax, and oil inspection fee. 317-615-2630 or fetax@dor.in.gov.

Who should file? Section A: Information
Anyone who purchased un-dyed special fuel or gasoline, paid the
Indiana excise tax, and oil inspection fee, and later used it for an Name – Enter the name of the individual or entity making the
exempt purpose. If the fuel is being used in a vehicle, the declared claim.
gross weight must be 26,000 pounds or less.
Address – Enter the location address.
Indiana Motor Carriers and IFTA Carriers should use Form MCS-
1789 to file a claim for refund. Telephone Number – Enter the phone number for the responsible
point of contact for completing the claim.
How do I file a Claim for Fuel Tax Refund (Form REF-1000)?
• File electronically via INTIME, DOR’s e-services portal, Social Security Number (SSN)/Federal Employer Identification
at intime.dor.in.gov. Number (FEIN) – If the claim is for an individual, enter the SSN. If
• Mail the completed claim and supporting documentation the claim is for an entity, enter the FEIN.
to the address listed on the front of the form.
• Email the completed claim and supporting Indiana Taxpayer Identification Number (TID) – Enter the
documentation to fetax@dor.in.gov. 10-digit TID. If you do not know the TID, leave this space blank.
What are some examples of exempt usage? Refund Period – Enter the beginning and ending dates of the
• Operating agricultural equipment (tractors, combines, period being claimed.
harvesters). Vehicles registered by the Indiana Bureau of
Motor Vehicles are not eligible for refund. Email Address – Enter the email address of the person
• Operating off-highway equipment (cranes, forklifts, responsible for completing the claim. If you do not have an email
sawmills, stationary engines, in-plant industrial use). address, leave this space blank.
• Using fuel for non-highway purposes (planes, trains,
home heating). Use of Fuel – Mark the appropriate box to indicate how the fuel
• Operating as a common carrier of passengers, including was used.
a taxicab as defined in Indiana Code 6-6-1.1-103(l).
• Operating a for-hire bus as defined in Indiana Code 9-13- Section B: Refund Computation
2-66.7. Separate refund forms must be filed for different gasoline
• Operating a public transportation vehicle or public transit and special fuel tax rates. Refer to the Tax Rate Table.
system.
• Operating a vehicle using mounted equipment with Example: Fuel is purchased for a non-taxable use for the period
a common fuel supply reservoir may qualify for a April 1, 2022 through September 30, 2022. Two refund claim
proportional use exemption. forms must be filed.
• Purchasing Indiana tax-paid fuel for export.
• Selling Indiana tax-paid fuel to the U.S. Government. 1 stclaim – April 1, 2022 through June 30, 2022
• Using Indiana tax-paid fuel to denature alcohol.
• Operating refrigeration units mounted on motor vehicles 2 ndclaim – July 1, 2022 through September 30, 2022
with a separate fuel tank exclusively for cooling.
Line 1 – Enter the amount from Section C, Line 11.
When should I file?
A claim for refund can be filed on a monthly, quarterly, semi- Line 2 – Enter the amount from Section D, Line 6.
annual or annual basis.
Line 3 –Line 1 plus Line 2.
Special fuel claims must be filed within three years of the date of
purchase. For example, you purchased special fuel on July 20, Line 4 – Enter the appropriate rate(s) from the table(s).
2020. You have until July 20, 2023 to file a claim for refund.
Line 5 – Multiply Line 3 by Line 4.
Gasoline claims must be filed by April 15 of the year succeeding
three years from the date of purchase. For example, you purchased Line 6 – Multiply Line 3 by .01 (Special Fuel Only).
gasoline on July 20, 2020. You have until April 15, 2024 to file a
claim for refund. Line 7 – Enter the sum of all collection allowance credits from
your invoices (Special Fuel Only).
What type of documentation is proof that tax was paid?
• Invoices/Receipts/Reports that include: Line 8 – Line 5 plus Line 6 minus Line 7.
o Name and address of seller
o Name of purchaser Line 9 – Line 8 gasoline plus Line 8 special fuel.
o Number of gallons purchased
o Date purchased
o Type of fuel purchased
o Amount of tax paid
• MF-360 (Consolidated Gasoline Monthly Tax Return)
• SF-900 (Consolidated Special Fuel Monthly Tax Return)
• Tax returns for other states showing gallons exported
from Indiana
1

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Section C: Exempt Use Details Section D: Proportional Use Exemption Details
This section must be completed if you used gasoline and/or Proportional use exemptions apply to fuel consumed by
special fuel for an exempt purpose. commercial equipment being used on a vehicle that shares a
common fuel reservoir. Each vehicle type must be listed on a
Complete Columns 1 through 5 if the fuel was used for an exempt separate line. If you operate a type of vehicle that is not listed,
reason other than the reasons listed in Lines 7 through 10. please contact our office at 317-615-2630 or fetax@dor.in.gov.
Column 1 – Enter the type of vehicle or equipment. Column 1 – Enter the type of vehicle from the list.
Column 2 – Enter the make and model. Column 2 – Mark the applicable box.
Column 3 - Indicate if the vehicle is licensed with the Indiana Column 3 – Enter the whole gallons consumed.
Bureau of Motor Vehicles.
Column 4 – Enter the applicable exemption percentage from the
Column 4 – Describe how the fuel was used in an exempt chart.
manner (e.g., plowing fields, building construction, home heating,
operating a taxicab). Column 5 – Multiply Column 3 by Column 4.
Column 5 – Enter the whole gallons consumed in an exempt Line 6 – Enter the total(s) from Column 5.
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 – Add Lines 6 through Line 10.

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