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Get Form 8849 (Schedule 5) (Rev. July 1999). Section 4081(e) Claims

E. Name as shown on Form 8849 Part I EIN or SSN Claim for Refund of Second Tax (a) Total amount of refund Type of fuel Do not use commas or $ signs. Dollars Cents 1 Gasoline (b) CRN 301 2 10% gasohol 3 7.7% gasohol 312 4 5.7% gasohol 5 Aviation gasoline 307 6 Diesel fuel 303 7 Kerosene Part II Supporting Information Required. See instructions. If more space is needed, attach separate sheets. Claimant certifies that the amount of the second tax has not been included in the price o.

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