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Get Form 8849 (Schedule 5) (Rev. January 2003 ) - IRS - Irs

Attach to Form 8849. Do not file with any other schedule. Name as shown on Form 8849 EIN Total refund (see instructions) $ Claimant s registration number. Part I Claim for Refund of Second Tax (a) Amount of refund Type of fuel 1 Gasoline (b) CRN 362 $ 2 10% gasohol 359 3 7.7% gasohol 375 4 5.7% gasohol 376 5 Aviation gasoline 324 6 Diesel fuel 360 7 Kerosene 346 Part II Supporting Information Required. See instructions. If more space is needed, attach separate shee.

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