Form Schedule 6 (Form 8 Schedule 6 (Form 8 Other Claims

Schedule 6
(Form 8849)

Other Claims
OMB No. 1545-1420

(Rev. January 2009)
©

Department of the Treasury
Internal Revenue Service

Attach to Form 8849.

Name as shown on Form 8849

EIN or SSN

Total refund (total of lines 1–5)

$

Enter the earliest and latest dates of the events included in this claim. Enter in MMDDYYYY format.
Earliest date

©

Latest date

©

Tax

Amount of refund

1

CRN

$

2
3
4
5
Use the space below for an explanation of each tax claimed.
For claims under section 6416(b)(2) relating to certain uses and resales of certain articles subject to manufacturers or retailers
taxes, claimant certifies that it sold the article at a tax-excluded price, repaid the amount of tax to the ultimate vendor, or has
obtained the written consent of the ultimate vendor to make the claim; and has the required supporting evidence.

What’s New

● Form 11-C, Occupational Tax and Registration Return for
Wagering.

For Form 720 claims under credit reference numbers (CRNs)
396, 304, and 305, include the number of taxable tires for each
CRN included in the claim.

Caution. Do not use Schedule 6 to make adjustments to liability
reported on Forms 720 filed for prior quarters. Instead, use Form
720X, Amended Quarterly Federal Excise Tax Return. Also, do
not use Schedule 6 to claim amounts that were taken or will be
taken as a credit on Form 2290 or Form 730.

General Instructions
Purpose of schedule. Use Schedule 6 for claims not reportable
on Schedules 1, 2, 3, 5, and 8, including refunds of excise taxes
reported on:
● Form 720, Quarterly Federal Excise Tax Return;
● Form 2290, Heavy Highway Vehicle Use Tax Return;
● Form 730, Monthly Tax Return for Wagers; and

Claim requirements. Generally, a claim must be filed within 3
years of the filing of the return to which the claim relates, or 2
years from when the tax reported on that return was paid,
whichever is later.
How to file. Attach Schedule 6 to Form 8849. Mail it to the IRS
at the address under Where To File in the Form 8849
instructions. If you attach additional sheets, write your name and
taxpayer identification number on each sheet.

For Privacy Act and Paperwork Reduction Act Notice, see Form 8849 instructions.

Cat. No. 27454M

Schedule 6 (Form 8849) (Rev. 1-2009)

Schedule 6 (Form 8849) (Rev. 1-2009)

Page

Form 720
A claim relating to the taxes listed below may be made. See
Pub. 510, Excise Taxes, for information on allowable claims
relating to these taxes. The following information must be
attached to the claim.
1. A detailed description of the claim.
2. Any additional information required by the regulations.
3. The amount of the claim. If the claim is for more than one
quarter, list the claim amounts by quarter.
4. How you figured the claim amount.
5. Any other information you believe will support the claim.
6. For CRNs 396, 304, and 305, include the number of taxable
tires for each CRN included in the claim.

Tax
Ozone-depleting chemicals
Truck, trailer, and semitrailer chassis and bodies,
and tractors
Passenger vehicles (luxury tax)
Taxable tires other than biasply or
super single tires
Taxable tires, biasply or super single tires

CRN
398

Taxable tires, super single tires
designed for steering
Gas guzzler automobiles
Vaccines
Sport fishing equipment
Fishing rods and fishing poles
Fishing tackle boxes
Electric outboard motors
Bows, quivers, broadheads, and points
Arrow shafts

305

383
392
396
304

340
397
341
308
387
342
344
389

Diesel-water fuel emulsion blending (CRN 310). The claim rate
for undyed diesel fuel taxed at $.244 (CRN 310) and used to
produce a diesel-water fuel emulsion is $.046 per gallon of diesel
fuel (blender claims).
Claim requirements. The amount claimed must be at least
$750. This amount may be met by making a claim during any
quarter of a claimant’s income tax year or aggregating amounts
from any quarters of the claimant’s income tax year for which no
other claim has been made. The amount claimed for a
diesel-water fuel emulsion may be combined with any amounts
claimed on Schedule 1 to meet the $750 minimum. The claim
must be filed during the first quarter following the last quarter
included in the claim. Only one claim may be filed per quarter.
Enter the earliest and latest date of the claim on page 1. If the
above requirements are not met, see Annual Claims in the Form
8849 instructions.
In addition to items 1–5 above, claimant must attach a
statement certifying that (a) the claimant produced a diesel-water
fuel emulsion containing at least 14% water, (b) the emulsion
additive is registered by a United States manufacturer with the
Environmental Protection Agency (EPA) under section 211 of the
Clean Air Act, (c) the claimant used undyed diesel fuel taxed at
$.244 to produce the diesel-water fuel emulsion and (d) the
claimant sold or used the diesel-water fuel emulsion in its trade
or business.
Claimant must be registered by the IRS and must enter their
registration number on the statement.

Form 2290, CRN 365
A claim for refund may be made for the following:
● An overpayment of tax due to a mistake in tax liability
previously reported on Form 2290.
Claimant. The claim is made by the person that paid the tax to
the government.

2

● A pro rata refund of the tax paid on Form 2290 for a vehicle
that was sold, destroyed, or stolen before June 1 of any period
(July 1–June 30) and subsequently not used during the period.
To make a claim for a vehicle that was sold, destroyed, or
stolen, the following information must be attached to
Schedule 6.
1. The vehicle identification number (VIN).
2. Whether the vehicle was sold, destroyed, or stolen.
3. Date of the sale, accident, or theft.
4. Computation of the refund amount. See the line 5
instructions for Form 2290.
Claimant. The claim is made by the person in whose name the
vehicle is registered at the time it was sold, destroyed, or stolen.
● Any vehicle on which the tax was paid on Form 2290 if the
vehicle was used 5,000 miles or less on public highways (7,500
or less for agricultural vehicles) during the period (July 1–June
30). The mileage limitation applies to the total mileage a vehicle
is driven during a period regardless of the number of owners of
the vehicle. A claim for this mileage refund cannot be filed until
after June 30 of the period.
Claimant. The claim is made by the person that paid the tax to
the government.

Form 730, CRN 368
A claim for refund may be made for an overpayment of tax.
The claim is not allowed unless a statement of the facts is
attached that includes the following information.
1. An explanation of the reason for claiming a refund.
2. The date of payment and the amount of the tax.
3. Whether any previous claim covering the amount involved,
or any part, has been filed.
4. A statement that you:
a. Have not collected (whether as a separate charge or
otherwise) the amount of the tax from the person that placed the
wager on which the tax was imposed,
b. Have repaid the amount of the tax to the person that placed
the wager, or
c. Have the written consent of the person that placed the
wager to the making of the refund (the consent must be
attached to the claim).
5. If the overpayment relates to a laid-off wager accepted by
you, one of the above three statements must be attached for
both the person that placed the laid-off wager and the person
that placed the original wager.
Claimant. The claim is made by the person that paid the tax to
the government.
Credit for wagers laid off by you. If you accept a wager and
lay off all or part of the wager with a person who is liable for the
tax and have paid the tax, a claim may be allowed for the tax
paid on the laid-off amount. No claim is allowed unless the
following information is attached to Schedule 6.
1. The certificate described in Regulations section
44.6419-2(d).
2. A statement that includes (a) the reason for the refund, (b)
the month in which the tax was paid, (c) the date of payment,
and (d) whether any previous claim covering the amount
involved, or any part, has been filed.
Claimant. The claim is made by the person that paid the tax to
the government.

Form 11-C, CRN 367
A claim for refund may be made for overpayment of tax due to a
mistake in tax liability previously reported on Form 11-C.
Claimant. The claim is made by the person that paid the tax to
the government.