Hawaii Certificate of Retail Sales of Liquid Fuel

Certificate of Retail Sales of Liquid Fuel
Form M-2, Rev. 2020, Certificate of Retail Sales of Liquid Fuel
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FORM M-2
(REV. 7/2020)

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STATE OF HAWAII — DEPARTMENT OF TAXATION

CERTIFICATE OF RETAIL SALES OF LIQUID FUEL

Name of Licensed Distributor From Whom the Liquid Fuel Was Purchased

Date of this Certificate

Name of Retail Dealer

Liquid Fuel Retail Dealer’s Permit Number

Mailing Address (Number and Street)

Federal Employer I.D. No. or Social Security Number

City, State, Postal/ZIP Code

RETAIL SALES FOR THE MONTH OF (MM-YY)

TYPES OF LIQUID FUEL*
Show Number of Gallons

(a)
CITY AND COUNTY
OF HONOLULU

(b)
ISLAND OF MAUI

(c)
ISLAND OF LANAI

(d)
ISLAND OF
MOLOKAI

(e) Add cols. b thru d
TOTALS
COUNTY OF MAUI

1)	Aviation............................................
2)	Diesel
	

2a)	 Used in small boats................

	

2b)	Used for all other purposes....

3)	 Naphtha (Power-Generating Facility)
4)	 Alternative Fuel
		Biodiesel...................................
		

Compressed Natural Gas.........

		Ethanol......................................
		

Liquefied Natural Gas...............

		LPG...........................................
		Methanol...................................
		Biodiesel Blend1........................
5)	Gasoline
	

5a)	 Used in small boats...................

	

5b)	Used for all other purposes.......

6)	 Total Gallons By County..................
*Note: THE INFORMATION IS NEEDED BY THE DISTRIBUTOR TO COMPLETE ITS FUEL TAX RETURN.		

DECLARATION BY RETAIL DEALER
The undersigned hereby certifies that, for myself and for the above named retail dealer, under the penalties provided by section 243-3(b), HRS:
• the permittee is the holder of a valid permit which is still in effect;
• the statements made in the permit application are true, correct, and complete as of this date;
• the permittee is maintaining the practices and records set forth in the application; and
• to the best of my knowledge and belief this certificate is a true, correct, and complete statement for the above mentioned period.

Signature	

Type or Print Name and Title	

Date

Licensed Distributors — Complete Page 2 of this Form

1	 	 Maui County Resolution No.19-100 created new fuel tax category effective July 1, 2019
2	 	 Maui County Resolution No. 20-82 increased the gasoline and diesel oil tax effective July 1, 2020

NOTE:	 Prepare this form 	
	
in DUPLICATE:
	 Original shall be
	
retained by the 	
	
licensed 		
	distributor.
	
 	Copy to be	
	 retained by the 	
	 retail dealer.

(f)
COUNTY OF HAWAII

(g)
COUNTY OF KAUAI

FORM M-2
(REV. 7/2020)

Page 2

COMPUTATION OF THE EVAPORATION ALLOWANCE DEDUCTION (To be completed by the licensed distributor)
TYPES OF LIQUID FUEL*
(Enter the amounts from the respective county’s column on page 1.)

(a)
CITY AND COUNTY
OF HONOLULU

(b)
COUNTY OF MAUI

(c)
COUNTY OF HAWAII

(d)
COUNTY OF KAUAI

32.5¢

40¢

39¢

33¢

2¢

2¢

2¢

2¢

32.5¢

40¢

39¢

33¢

7)	 On Highway Diesel Oil and Liquid Fuel — Add lines 2b (On Public
Highway use) and 5b, enter here.
8)	 Divide line 7 by 99, enter here.
9)	 Diesel Oil and Liquid Fuel — County tax rates
10)	 Evaporation allowance deduction for on highway diesel oil and
liquid fuel — Multiply line 8 by line 9, enter here.
11)	 On Highway - Alternative Fuel — Enter the amount from line 4 which
was used On Public Highways. (See instructions.)
12)	 Divide line 11 by 99, enter here.
13)	 Enter the applicable alternative fuel tax rate. (See instructions.)
14)	 Evaporation allowance deduction for on highway - alternative fuel —
Multiply line 12 by line 13, enter here.
15)	 Off Highway Aviation and Diesel Oil — Add lines 1 and 2b (Off Public
Highway Use). (Report diesel oil used in small boats on line 22)
16)	 Divide line 15 by 99, enter here.
17)	 Evaporation allowance deduction for off highway aviation and
diesel oil — Multiply line 16 by 1¢(.01), enter here.
18)	 Off Highway Naphtha — Enter the amount from line 3.
19)	 Divide line 18 by 99, enter here.
20)	 Naphtha fuel tax rate
21)	 Evaporation allowance deduction for off highway naphtha —
Multiply line 19 by line 20, enter here.
22)	 Small Boats - Diesel Oil — Enter the amount from line 2a which was
used in small boats.
23)	 Divide line 22 by 99, enter here.
24)	 Evaporation allowance deduction for small boats - diesel oil —
Multiply line 23 by 1¢(.01), enter here.
25)	 Small Boats - Gasoline — Enter the amount from line 5a which was
used in small boats.
26)	 Divide line 25 by 99, enter here.
27)	 Liquid Fuel — County tax rates
28)	 Evaporation allowance deduction for small boats - gasoline —
Multiply line 26 by line 27, enter here.
29)	 Total evaporation allowance deduction for retail sales of fuel by
county — Add lines 10, 14, 17, 21, 24, and 28, enter the total here.

FORM M-2
(Rev. 7/2020)