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Get Form 8849 (schedule 4) (rev. July 1999). Sales By Gasoline Wholesale Distributors

Orm 8849 EIN or SSN Enter the earliest and latest dates of sale included in this claim. Earliest date: Latest date: (mo., day, year) (mo., day, year) Claimant certifies that it bought gasoline, gasohol, or aviation gasoline at a price that included the excise tax. Claimant qualifies as a gasoline wholesale distributor, sold the fuel at a tax-excluded price, and obtained a certificate of ultimate purchaser or proof of export from the buyer. Type of Fuel (a) Type of use (b) Rate In cents p.

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