Official Nebraska Government Website

Forms

Motor Fuels HomeFormsNews & InfoFrequently Asked QuestionsElectronic FilingLicenseesStatisticsLegal InformationContact UsRevenue Home

Horizontal Rule

Printing Instructions

Selecting a form below will load it into the acrobat reader, which will allow you to print it. Install the Acrobat Reader if you do not yet have it installed on your computer. Instructions are included with each form.

Some of these forms are available in a "Fill-in" format, meaning you can view, complete and print the form on your computer. These forms use the features provided with Adobe Acrobat. Currently, there is no computation, validation, or verification of the information you enter, and you are still responsible for entering all required information. Instructions may require some information to be handwritten on the form (signatures, for example).

Note: The Acrobat Reader does not allow you to save your completed forms. You should print 2 copies to have one to keep for your records.

If you experience problems with downloading forms, it is recommended that you upgrade to at least Adobe Reader 5.0. Please note that the "Fill-in" forms are a larger file size and will take longer to download.

Horizontal Rule

Applications

Form 20MF, Nebraska Motor Fuels License Application (12/2007)
[Fill-in Form 20MF]
Form 21MF, Motor Fuels Application for Abatement of Penalty (12/2004)
[Fill-in Form 21MF]
Form 70, Nebraska Motor Fuels Tax Bond (8/2007)
[Fill-in Form 70]
Form70XN, Nebraska Motor Fuels Tax Bond Rider (8/2007)
[Fill-in Form 70XN]
Form 84, Nebraska Non-Ag Use Motor Fuels Tax Refund Claim (12/2007)
[Fill-in Form 84 ]
Refund Rate Table
Form84AG, Nebraska Ag Use Motor Fuels Tax Refund Claim (12/2007)
[Fill-in Form 84AG]
Form 872N-MF - Nebraska Extension of Statute of Limitations Agreement for Motor Fuels Programs (3/2005)
[Fill-in Form 872N-MF]
Form 91EX, Tax Exempt Certificate for Purchase of Diesel Fuel (12/2007)
[Fill-in Form 91EX]
Form 96, Nebraska Floor Stocks Tax Return for Ethanol (E-100) Only (12/2004)
[Fill-in Form 96]
Form RC73, Nebraska Retailer's Claim for Exempt Sales of Motor Fuels (12/2007)
[Fill-in Form RC73]

Tax Returns

Effective January 1, 2002, paper returns were eliminated and EDI (electronic data interchange) became the only filing method available. On January 1, 2005, the Form 73 was modified to include reporting of environmental fees (PRF), aircraft fuel tax liabilities, and compressed fuels thereby eliminating the Forms 82 - Petroleum Release Remedial Action Fee Return and the Form 85 - Nebraska Aircraft Fuels Tax Return. Also on January 1, 2005, a new EDI return was introduced exclusively for ethanol and biodiesel producers, the Form 83 - Nebraska Ethanol and Biodiesel Producer's Return and supporting schedules.

We do maintain the ability for certain returns to be filed "on-line." This is limited to the Forms 74, 80, and 86. A registration process is required to obtain permission to file these "on-line" forms. 

Pre-written software is available from commercial software providers listed under the "Electronic Filing" section of our Web site. Those filers electing to develop their own filing software will find mapping instructions located under the "2005 EDI Implementation Guide" located on this same section of our Web site.

The following "sample" returns and schedules are provided to illustrate how the various liabilities are computed. Only EDI returns may be submitted.

Form 73 MFD - Nebraska  Multiple Schedule of Disbursements (4/2007)
Form 73 MFR - Nebraska  Multiple Schedule of Receipts (4/2007)
Form 73 - Nebraska Monthly Fuel Tax Return (1/2005)
Form 80 - Nebraska Motor Fuels Carrier Report with Motor fuels Diversion
Schedule (8/2007)
Form 83 MFD - Nebraska Producer's Schedule of Disbursements (4/2007)
Form 83 MFR - Nebraska Producer's Schedule of Receipts (4/2007)
Form 83 - Nebraska Ethanol & Biodiesel Producer's Return (1/2005)
Form 87 - Nebraska Motor Fuels Terminal Operator Report (6/2005)
  Nebraska Motor Fuels Teminal Operator Schedule of Disbursements, Form 87 (4/2007)
  Nebraska Motor Fuels Terminal Operator Schedule of Receipts, Form 87 (4/2007)
 

Horizontal Rule