Name: |
EIN: |
Address: |
Registration No: |
City, State, Zip |
|
"AB" QUESTIONNAIRE (Revision 02-01-2006)
Producers and importers of agri-biodiesel. Agri-biodiesel is the fuel made from virgin vegetable oils and animal fats.
Review Form 637, "Application for Registration" for any updates or changes. This includes Part I, II, and III. Attach the updates or changes to questionnaire. Notate if no updates or changes have been made since last visitation.
Who is responsible for the preparation and filing of Form 8849 or Form 4136? From what address are they filed? _________________________________________________________________________________________________________________________________________________________________________________________________________
Does the company, related company, or any of its owners incur any liability for excise tax? If so, name the type of tax. ______________________________________________________________________________________________________________________________________
Does the company sell or plan to sell any agri-biodiesel fuel to a related company? If so, describe the arrangements.
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Has the company's excise, employment, or income tax returns been examined by the State or IRS during the previous five years? If so, what were the results of the examination?
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
List the name and address of all the company's suppliers of agri-biodiesel fuel.
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Does the company store any agri-biodiesel fuel to which it does not hold title? If so, where is this inventory stored? For whom is it stored? Are separate inventory records maintained?
_________________________________________________________________________________________________________________________________________________________________________________________________________
List all locations and storage facilities where agri-biodiesel fuel is stored. List the expected volume (in gallons) of agri-biodiesel fuel sold to these entities. Attach additional sheets if needed. (CEP and major oil companies may be exempted from this question.)
Name of Facility |
Address of Facility |
Capacity of the Agri-Biodiesel Fuel Tank(s) |
Expected Annual Volume |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Please list the types of agri-biodiesel being produce and imported.
__________% Agri-biodiesel (derived solely from virgin oils, including esters derived from virgin vegetable oils from corn, soybeans, sunflower seeds, cottonseeds, canola, crambe, rapeseeds, safflowers, flaxseeds, rice bran, and mustard seeds and from animal fats.
Is the agri-biodiesel produced or imported by you a pure fuel or is it blended with
petroleum diesel? If yes, please list the percentage of blend.
__________ % by volume agri-biodiesel.
__________ % by volume petroleum diesel
Please list all production agreements with agri-biodiesel marketing firms that you plan on implementing with the year.
Are you or your customers reimbursed for the federal excise tax on agri-biodiesel fuel for any credit card sales? If so, explain.
_________________________________________________________________________________________________________________________________________________________________________________________________________
What are your procedures for securing exemption certificates from customers who purchase without the federal excise tax?
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
List the names and addresses of all customers that you have sold or plan to sell agri-biodiesel without the federal excise tax? Indicate with an * any customer who purchases in bulk quantities.
_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Do you sell agri-biodiesel as a distributor?
_____________________________________________________________________
Does the company store any agri-biodiesel fuel to which it does not hold title? If so, where is this inventory stored? For whom is it stored? Are separate inventory records maintained? Who is filing claims for the production or importation of the fuel?
_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Do you sell agri-biodiesel on consignment? If so, where is this inventory stored? For whom is it stored? Are separate inventory records maintained? Who is filing claims for the production or importation of the fuel?
_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
17. Do you export or plan to export any agri-biodiesel fuel product?
TIN - DATE -
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | "UP" QUESTIONNAIRE |
Author | National Office Excise |
File Modified | 0000-00-00 |
File Created | 2021-02-03 |