Fill/Calc = Fillable Forms that Calculate
Fillable = Fillable Forms that Do Not Calculate
Print Only = Print Only Forms that Do Not Fill-In or Calculate
Fillable = Fillable Forms that Do Not Calculate
Print Only = Print Only Forms that Do Not Fill-In or Calculate
Motor Fuel Tax Forms
Note: Forms 455, 455A, 455B, and 455C (for motor fuel tax refunds) are no longer available. Please use Forms 4923, 4924, and 4925 instead.
Motor Fuel Refund Forms
| Form Number | Description |
|---|---|
| Form 4923 — Fillable | Motor Fuel Refund Claim (08/2007) |
| Form 4924 — Fillable | Motor Fuel Refund Application (10/2007) |
| Form 4925 — Fillable | Schedule A — Marine Fuel Purchases By County (11/2007) |
| Form 588A — Fillable | Schedule C — Auxiliary Equipment Deduction Schedule (11/2005) |
| Form 5085 — Fillable | Bulk Deliveries of Agricultural Gasoline (12/2005) |
Licensing & Bonding Forms
| Form Number | Description |
|---|---|
| Form 795 — Fillable | Missouri Motor Fuel Tax License Application (11/2006) |
| Form 670 — Fillable | Motor Fuel Tax Surety Bond (11/2007) |
| Form 2789 — Fillable | Motor Fuel Tax Cash Bond (11/2007) |
| Form 2796 — Fillable | Fuel Tax Registration Change Request (10/2007) |
| Form 2879 — Fillable | Irrevocable Letter of Credit (10/2006) |
| Form 4752 — Fillable | Distributor's Pool Bond Agreement (10/2007) |
| Form 4753 — Fillable | Assignment of Certificate of Deposit — Fuel Tax (11/2007) |
Supplier Monthly Reporting Forms
| Form Number | Description |
|---|---|
| Form 572 — Fillable | Supplier/Permissive Supplier's Monthly Tax Report (11/2007) |
| Form 573 — Fillable | Schedule of Supplier Tax-Paid Receipts (11/2007) |
| Form 591 — Fillable | Supplier Schedule of Delinquent Tax Collection (11/2007) |
| Form 2994 — Fillable | Schedule of Supplier/Permissive Supplier Terminal Rack Removals (11/2007) |
| Form 4758 — Fillable | Schedule of Supplier State Diversion Corrections (11/2007) |
| Form 4760 — Fillable | Supplier Notification of Uncollectable Tax (11/2006) |
| 8A — Fillable | 8A Affidavit for Bad Debt Loss (11/2007) |
Distributor Monthly Reporting Forms
| Form Number | Description |
|---|---|
| Form 4757 — Fillable | Distributor's Monthly Tax Report (11/2007) |
| Form 574 — Fillable | Distributor's Schedule of Receipts (11/2007) |
| Form 587 — Fillable | Schedule of Distributor Disbursements (11/2007) |
| Form 4776 — Fillable | Federal Government Exemption Certificate (11/2006) |
| Form 1531 — Fillable | Fuel Delivered for Marine Use (11/2007) |
Transporter Monthly Reporting Forms
| Form Number | Description |
|---|---|
| Form 1536 — Fillable | Transporter Report of Deliveries (11/2007) |
| Form 4782 — Fillable | Transporter Report (11/2007) |
Terminal Monthly Reporting Forms
| Form Number | Description |
|---|---|
| Form 575 — Fillable | Terminal Operator Report (11/2007) |
| Form 3008 — Fillable | Schedule of Terminal Operator Disbursements (11/2007) |
| Form 4754 — Fillable | Schedule of Terminal Operator Receipts (11/2007) |
| Form 4785 — Fillable | Schedule of Terminal Operator Inventories Schedule 1/7A (11/2006) |
Miscellaneous Motor Fuel Reporting Forms
| Form Number | Description |
|---|---|
| Form 11A — Fillable | K-1 Kerosene Exemption Certificate (11/2007) |
| Form 2992 — Fillable | Fuel Tax Exemption Certificate — Sales to U.S. Government (11/2007) |
| Form 4707 — Fillable | Three Day Import Payment Voucher (11/2006) |
| Form 4755 — Fillable | Notification of Loss of Motor Fuel (11/2006) |
| Form 4756 — Fillable | Affidavit for Loss of Motor Fuel (11/2007) |
| Form 4759 — Fillable | Schedule of Pool Bond — Bond Contributions — 5T (11/2007) |
| Form 4783 — Fillable | Consumer Payment Voucher (11/2006) |
| Form 5084 — Fillable | Agricultural Gas Bulk Sale Exemption Certificate (11/2007) |
| Form 5141 — Fillable | Public Mass Transportation Operator Exemption Certificate (11/2007) |