Motor Fuel Forms

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Current year Motor Fuel tax forms and associated schedules are listed below. Contact the department at 517-636-4600 if you need prior year forms.

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Motor Fuel Forms and Associated Schedules

Form Number Form Name Associated Schedules
  Refund Request Notice  
577 Dealers Liquid Petroleum Gas Return  
3712 Motor Fuel Tax License Application 702, Motor Fuel, Motor Carrier or Tobacco Surety Bond Form
3715 Carrier's Monthly Report: Pipeline, Barge, Marine Vessel 3788, Carrier Schedule of Deliveries
3716 Terminal Operator Monthly Report
3780, Schedule 15A — Terminal Operator Schedule of Receipts — Michigan Terminals Only
3781, Schedule 15B — Terminal Operator Schedule of Disbursements
3724 Transporter Quarterly Report 3779, Transporter Schedule of Deliveries or Diversions (803-TS)
3739 Eligible Purchaser Application to Defer Payment 702, Motor Fuel, Motor Carrier or Tobacco Surety Bond Form
3740 Request for Extension of Eligible Purchaser Agreement 3859,Eligible Purchaser Surety Bond Form
3769 (Dec 2016 and before) Retail Marine Diesel Dealer Return
3767, Schedule 1: Retail Marine Diesel Dealer Schedule of Receipts
4429, Retail Marine Diesel Dealer Schedule of Disbursement
3769 (Jan 2017 and after) Retail Marine Diesel Dealer Return  
3778 Three Day Payment Voucher  
3791 (Dec 2016 and before) Blender Monthly Return
3750, Schedule of Diversions
3817, Blender Schedule of Receipts
4124, Blender Schedule of Disbursements
3791 (Jan 2017 and after) Blender Monthly Return  
3823 Aviation Fuel Registrant Application  
3877 (Dec 2016 and before) Terminal Operator Annual Return  
3877 (Jan 2017 and after) Terminal Operator Annual Return  
3877(*) Terminal Operator Annual Return
* NOTE: Due Date 2/25/08
 
3978 (Dec 2016 and Before) Fuel Supplier Return
3750, Schedule of Diversions
3783, Supplier Schedule of Receipts
3784, Supplier Schedule of Disbursements
3978 (Jan 2017 and after) Fuel Supplier Return
3992 (Dec 2016 and before) Fuel Importer Return
3748, Importer Schedule of Receipts
3749, Importer Schedule of Disbursements
3750, Schedule of Diversions
3992 (Jan 2017 and after) Fuel Importer Return
3999 Motor Fuel/Tobacco Trading Partner Agreement
4040,Motor EFT Credit Application
4041,Motor EFT Debit Application
4099, Motor Fuel Electronic Filing Application
4004 Exporter Quarterly Report (540-EXP) 4012, Schedule of Exports
4099 Motor Fuel Electronic App
3999, Motor Fuel/Tobacco Trading Partner Agreement
4040,Motor EFT Credit Application
4041,Motor EFT Debit Application
4334 (Dec 2016 and before) Motor Fuel Untaxed Products Return  
4334 (Jan 2017 and after) Motor Fuel Untaxed Products Return  
4360 (Dec 2016 and before) IFTA Bus Schedule  
4360 (Jan 2017 and after) IFTA Bus Schedule  
4667 Michigan Fuel Product Codes  
5494 Alternative Fuel Dealer’s Monthly Tax Return  
5495 Alternative Fuel Commercial User Monthly Tax Return  
Payments
4020 Motor Fuel Tax Payment/Proposed Adjustments Coupon  
4040 Motor Fuel Electronic Funds Transfer (EFT) Credit Application  
4041 Motor Fuel Electronic Funds Transfer (EFT) Debit Application  

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