Natural Gas Use Tax — Form & Instructions

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# Natural Gas Use Tax Addendum

Effective July 1, 2018 to December 31, 2025
Use black ink and attach original form to your Excise Tax Return.

# Account information

Name:
Account ID:
Period Year
Check box if public utility tax was paid on entire purchase or natural gas was not purchased for this period. (This addendum must be filed even if no tax is due.)

# 2 State natural gas use tax

1. Volume in therms [122]:

Purchase price [121]:
Transportation charges [12171]:
Total value:

1. Total state tax due (multiply the total value in line 1, by the tax rate .03852):

# 3 Local city natural gas use tax [141]

For each line, multiply total city value by the local rate to get the city tax due. Note: To find the local city code rate and local rate in which you used your natural gas, see the bottom of page 2.
Line Local city code Total city value Local rate City tax due
3.
4.
5.
6.
7.
8.
9.

1. Total city value (add lines 3-9): Total city tax due (add lines 3-9):

# 4 State credit(s)

Consumer paid use tax:
Seller paid state gross receipts:

1. Total state credit:

# 5 Local city credits

Line
Local city code
Consumer paid use tax
Seller paid municipal gross receipts
Total local credit
12.
13.

1. Total state/city credit(s) (add lines 11-13):

# 6 Totals

1. Total tax due (add line 2 and line 10):
2. Total credit (line 14):
3. Total amount due (subtract line 16 from line 15):

Add all the addendum totals and transfer the amount to the total all addendums line on your tax return.

# Local city codes and tax rates

Either the public utility tax or the natural gas use tax is due on purchases of natural gas.
Important: Include your tax registration number on all correspondence and checks.
State natural gas use tax
Volume (in therms): Enter a whole number for the total volume (in therms) of gas delivered this period. If your company received natural gas in more than one location, enter the total volume for all locations. This information will be cross-matched with the quarterly reports required from the local distribution companies.
1 MMBTU = 10 therms OR 1 therm = 100,000 BTU's.
Purchase price: Enter only the purchase price of the gas. Do not include transportation charges.
Transportation charges: Enter the amount of separately stated interstate and intrastate transportation charges that were not subject to public utility tax.
Total value: Add the purchase price and the transportation charges and enter the total.
Total state tax due: Multiply the total value by .03852 and enter the result.
Local city natural gas use tax
From the chart below, find the city and tax rate in which you used your natural gas.
Enter the four-digit code for your city in the "Loc. City Code" column.
Enter the total value, local rate, and calculate the city tax due for each location.
Note: If your natural gas was used at a county address, you only need to complete the state portion of this tax.
State and local city credit(s)
If you paid tax to another state on gas used, you may be able to take that amount as a credit. Prorate the credit to the state and city portion (if applicable) of the tax based on the relative rates of the taxes.
How to report prior period adjustments
Make a copy of the original return, cross out the incorrect information and write in the correct information.
You may also use a blank Natural Gas Use Tax Addendum by filling in the correct information. For either method, write "amended" at the top and include a letter of explanation.

# Local city codes and tax rates

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