Blank Texas 06 170 PDF Form Get Texas 06 170 Here

Blank Texas 06 170 PDF Form

The Texas 06-170 form is a document used to report tax-free purchases of dyed diesel fuel by bonded users in Texas. This form must be completed by individuals or businesses that buy dyed diesel fuel without paying taxes, ensuring compliance with state regulations. Accurate completion of the form is essential to avoid potential penalties or collection actions.

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The Texas 06-170 form serves as a crucial document for individuals and businesses that purchase dyed diesel fuel tax-free from licensed sellers. This form is specifically designed for dyed diesel fuel bonded users, ensuring compliance with state tax regulations. It requires the submission of essential details, including the taxpayer number and name of the seller, product type, date of removal, shipping document number, and invoiced gallons. Each section must be completed accurately, and it is important to only write in the designated white areas of the form. If any preprinted information is incorrect, users should correct it directly on the form. The total invoiced gallons from all pages must be calculated and reported on the Texas Dyed Diesel Fuel Bonded User Tax Report, Form 06-169. Filing this schedule is mandatory for all eligible users; failure to do so could lead to collection actions as outlined in Texas tax law. For assistance, the Texas State Comptroller's Office provides resources and support for any questions related to fuel taxes.

Texas 06 170 Preview

06-170 (Rev.3-06/2)

a.

b.

 

DO NOT WRITE IN S HADED AREAS

TEXAS SCHEDULE OF TAX-FREE

 

 

 

c. Taxpayer number

PURCHASES OF DYED DIESEL FUEL

 

 

 

 

 

 

 

e. Taxpayer name

 

 

 

 

 

 

 

TYPE o r PRINT

d. Filing period

f.

 

1.

Seller name

 

 

2. Seller taxpayer number

 

 

 

 

 

 

 

 

3.

Product type

4. Date removed

5. Shipping doc. no.

 

6. Invoiced gallons

 

 

 

 

 

 

 

 

1.

Seller name

 

 

2. Seller taxpayer number

 

 

 

 

 

 

 

 

3.

Product type

4. Date removed

5. Shipping doc. no.

 

6. Invoiced gallons

 

 

 

 

 

 

 

 

1.

Seller name

 

 

2. Seller taxpayer number

 

 

 

 

 

 

 

 

3.

Product type

4. Date removed

5. Shipping doc. no.

 

6. Invoiced gallons

 

 

 

 

 

 

 

 

1.

Seller name

 

 

2. Seller taxpayer number

 

 

 

 

 

 

 

 

3.

Product type

4. Date removed

5. Shipping doc. no.

 

6. Invoiced gallons

 

 

 

 

 

 

 

 

1.

Seller name

 

 

2. Seller taxpayer number

 

 

 

 

 

 

 

 

3.

Product type

4. Date removed

5. Shipping doc. no.

 

6. Invoiced gallons

 

 

 

 

 

 

 

 

1.

Seller name

 

 

2. Seller taxpayer number

 

 

 

 

 

 

 

 

3.

Product type

4. Date removed

5. Shipping doc. no.

 

6. Invoiced gallons

 

 

 

 

 

 

 

 

1.

Seller name

 

 

2. Seller taxpayer number

 

 

 

 

 

 

 

 

3.

Product type

4. Date removed

5. Shipping doc. no.

 

6. Invoiced gallons

 

 

 

 

 

 

 

 

1.

Seller name

 

 

2. Seller taxpayer number

 

 

 

 

 

 

 

 

3.

Product type

4. Date removed

5. Shipping doc. no.

 

6. Invoiced gallons

 

 

 

 

 

 

 

 

1.

Seller name

 

 

2. Seller taxpayer number

 

 

 

 

 

 

 

 

3.

Product type

4. Date removed

5. Shipping doc. no.

 

6. Invoiced gallons

 

 

 

 

 

 

 

 

1.

Seller name

 

 

2. Seller taxpayer number

 

 

 

 

 

 

 

 

3.

Product type

4. Date removed

5. Shipping doc. no.

 

6. Invoiced gallons

 

 

 

 

 

 

 

 

1.

Seller name

 

 

2. Seller taxpayer number

 

 

 

 

 

 

 

 

3.

Product type

4. Date removed

5. Shipping doc. no.

 

6. Invoiced gallons

 

 

 

 

 

 

 

 

1.

Seller name

 

 

2. Seller taxpayer number

 

 

 

 

 

 

 

 

3.

Product type

4. Date removed

5. Shipping doc. no.

 

6. Invoiced gallons

 

 

 

 

 

 

 

TOTAL INVOICED GALLONS FOR ALL PAGES (Enter on Item 2 of

Texas Dyed Diesel Fuel Bonded User Tax Report, Form 06-169)

TOTAL INVOICED GALLONS

(Sum of Item 6)

FOR THIS PAGE ONLY

Form 06-170(Back)(Rev.3-06/2)

TEXAS SCHEDULE OF TAX-FREE

PURCHASES OF DYED DIESEL FUEL

Yo u hav e c e rtain rig hts under Ch. 559, Government Code, to review, request, and correct information

we have on file about you. Contact us at the address or toll-free number listed on this form.

WHO MUST FILE

Every dyed diesel fuel bonded user must file this schedule if they purchase dyed diesel fuel tax-free from other fuel license holders. Failure to file this schedule may result in collection action as prescribed by Title 2 of the Tax Code.

FOR ASSISTANCE

For assistance with any Texas Fuels tax questions, please contact the Texas State Comptroller's Office at 1-800-252-1383 toll-free nationwide, or call 512-463-4600.

GENERAL INSTRUCTIONS

Please write only in white areas.

TYPE or PRINT all information

Complete all applicable items that are not preprinted.

If any preprinted information is not correct, mark out the incorrect item and write in the correct information.

ROUND ALL GALLONAGE FIGURES TO WHOLE GALLONS.

SPECIFIC INSTRUCTIONS

Item 1 - Enter the name of the seller.

Item 2 - Enter the 11-digit taxpayer number of the seller of the fuel.

Item 3 - Enter the three-digit product type. 228 - Dyed Diesel Fuel

072 - Dyed Kerosene.

Item 4 - Enter the date, MM/DD/YY, as it appears on the Shipping Document/Bill of Lading. This is the date the fuel was PHYSICALLY REMOVED from a terminal or bulk plant. May be left blank if summarizing transactions. See item #5.

Item 5 - Enter the Shipping Document/Bill of Lading number. This is the identifying number from the document issued at the terminal or bulk plant when the product is removed. You may report the summary of multiple transactions when the seller and product type are the same. Enter the word 'SUM.' You must maintain detailed records of the transactions reported as a summary.

Item 6 - Enter invoiced gallons. You may report the summary of multiple transactions. See item #5.

Document Specs

Fact Name Description
Form Purpose The Texas 06-170 form is used to report tax-free purchases of dyed diesel fuel by bonded users.
Who Must File Every dyed diesel fuel bonded user who purchases dyed diesel fuel tax-free from other fuel license holders is required to file this schedule.
Filing Consequences Failure to file the 06-170 form may lead to collection actions as outlined in Title 2 of the Texas Tax Code.
Governing Law This form is governed by the Texas Tax Code and Chapter 559 of the Government Code.
Submission Guidelines All information must be typed or printed in the white areas of the form. Round all gallonage figures to whole gallons.
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