*Special
fuel consists of diesel, kerosene and CNG. |
#
Note: Combined taxable gallons (a+b) consumed on KY
public highways must equal line 5.
# # Note: Combined tax paid gallons (a+b) cannot be
greater than total gallons line 2. |
| I
declare under penalty of perjury that this report is true, correct,
and complete to the best of my knowledge and belief. |
|
Signature:________________________________________ |
|
Phone
#:
|
Please print 2 copies of this page. Keep one to maintain for
your records.
|
MAKE
CHECKS PAYABLE TO: KENTUCKY STATE TREASURER and mail to:
TRANSPORTATION
CABINET
DIVISION OF MOTOR CARRIERS
PO BOX 2004
FRANKFORT KY 40602-2004
Phone: 502-564-4150
For
overnight delivery, please send to: Division of Motor Carriers, 200
Mero Street, Frankfort, KY 40622
Helpful
hints/reminders
-
Make
sure the return is signed.
-
Write
quarter and KIT# on check and stub.
-
If
submitting a previous quarter, highlight quarter ending.
-
If
checking one of the boxes above, highlight boxes checked.
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Division
of Motor Carriers Home Page
If
you experience trouble completing the application, please contact the
Division of Motor Carriers @ 502.564.4150 Monday-Friday between 8:00
and 4:30 EST. |