Hawaii Combined Claim for Refund of Fuel Taxes under Chapter 243

Combined Claim for Refund of Fuel Taxes under Chapter 243
Form M-36, Rev 7/2020, Combined Claim for Refund of Fuel Taxes Under Chapter 243, HRS
Clear Form
STATE OF HAWAII - DEPARTMENT OF TAXATION

FORM

M-36

(REV. 7/2020)

QUARTERLY COMBINED CLAIM FOR
REFUND OF FUEL TAXES
UNDER CHAPTER 243, HRS

Name	

• PRINT OR TYPE •

THIS SPACE FOR DATE RECEIVED STAMP

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

	
DBA or C/O	

Hawaii Tax I.D. No. (LF-###-###-####-##)

LF–

		
Mailing Address (Number and Street)	

Period Beginning (MM-YY)

City or Town, State, and Postal/ZIP Code. If foreign address, see Instructions.	

Period Ending (MM-YY)

NOTE: All claims are to be filed with the Department of Taxation on or before the 20th day of the month following the close of the filing period.
GASOLINE
(GALLONS)

STATEMENT OF FUEL TRANSACTIONS AND REFUND DUE
1.

On hand at beginning of period

1.

2.

Purchases

2.

3.

Total (Add lines 1 and 2)

3.

4.
5.

Use Off Public Highways or Other Exempt Purposes
(Enter amount(s) in the appropriate column(s) on page 2.)
Used for other taxable purposes
(State purpose:                   )

DIESEL OIL
(GALLONS)

ALTERNATIVE FUEL
(GALLONS)

4.
5.

6.

Total (Add lines 4 and 5)

6.

7.

On hand at end of period (Line 3 less line 6)

7.

8.

REFUND ON GALLONS USED OFF PUBLIC HIGHWAYS
or OTHER EXEMPT PURPOSES
8. 
(Use the computation(s) on page 2 to calculate refund.)

9.

TOTAL REFUND AMOUNT (Add all amounts on line 8) ....................................................................................

10.

Used in the County of (Check only one):
(File separate claim for each county)

10.

11.

Name of seller(s)

11.

$

	

$

o Honolulu	

o Maui	

$
9. 

o  Hawaii	

$

o  Kauai

DECLARATION
I declare, under the penalties set forth in section 231-36, HRS, that this is a true, correct, and complete return, prepared in accordance with the provisions of chapter 243,
HRS, the Fuel Tax Law, and chapter 18-243, HAR. By checking this box and signing below,
I attest that the fuel reported on line 4 meets one of the following conditions making it eligible for a refund of fuel taxes paid: (a) The fuel tax was imposed and collected
because the purchaser failed to furnish an Exemption Certificate but, in fact, the fuel was ultimately used off the public highways, or other exempt purposes; or (b) The fuel
purchased was initially intended for use upon the public highways but was subsequently used off the public highways. For gasoline, the use was for operating agricultural
equipment off the public highways.

					
				

(   )
Signature	

Type or Print Name and Title	

Date	

Daytime Phone Number	

FORM M-36
(REV. 7/2020)
M36_I 2020B 01 VID01

ID NO 01

FORM M-36
(REV. 7/2020)					SCHEDULE OF TAX RATES

PAGE 2

SCHEDULE I. GASOLINE AND DIESEL OIL
APPLICABLE
TAX

TYPE OF
FUEL

CITY & COUNTY
OF HONOLULU

COUNTY
OF MAUI

COUNTY
OF HAWAII

COUNTY
OF KAUAI

State

Gasoline
Diesel Oil
Gasoline
Diesel Oil

15¢
15¢
16.5¢
16.5¢

15¢
15¢
24¢e
24¢e

15¢
15¢
23¢c
23¢c

15¢
15¢
17¢
17¢

County

COMPUTATION OF TAX REFUND
			

Gasoline					

Diesel Oil

State Tax	
15¢  x  	
Gals.1 =  $		
	
15¢ x 			Gals.1 =  $	
County Tax:
	 Honolulu	
16.5¢ x 	
Gals. = $		
	
16.5¢ x 			Gals. = $	
	Maui	
24¢e x 	
Gals. = $		
	24¢e x 			Gals. = $	
	Hawaii	
23¢c x 	
Gals. = $		
	23¢c x  			Gals. = $	
	Kauai	
17¢ x 	
Gals. = $		
	
17¢ x 			Gals. = $	
Refund on Gallons Used Off Public Highways or
Other Exempt Purposes		         $		
				        $	
			         (Enter amount(s) in the appropriate column(s) on line 8 – Front Page)

	
	
	

SCHEDULE II. ALTERNATIVE FUEL
APPLICABLE
TAX

TYPE OF
FUEL

CITY & COUNTY
OF HONOLULU

COUNTY
OF MAUI

COUNTY
OF HAWAII

COUNTY
OF KAUAI

State

Biodiesel
Compressed Natural Gas
Ethanol
Liquefied Natural Gas
LPG
Methanol
Biodiesel Blend
Biodiesel
Compressed Natural Gas
Ethanol
Liquefied Natural Gas
LPG
Methanol
Biodiesel Blend

4¢
4¢b
2.4¢
4¢a
5.2¢
1.9¢
0.0¢
8.3¢
8.2¢b
2.4¢
8.2¢a
5.4¢
1.8¢
0¢d

4¢
4¢b
2.4¢
4¢a
5.2¢
1.9¢
3.9¢d
0¢
11.9¢b,e
11.5¢e
11.9¢a,e
11.5¢e
11.5¢e
6¢d

4¢
4¢b
2.4¢
4¢a
5.2¢
1.9¢
0.0¢
0¢
11.4¢b,c
3.3¢c
11.4¢a,c
7.6¢c
2.5¢c
0¢d

4¢
4¢b
2.4¢
4¢a
5.2¢
1.9¢
0.0¢
0¢
8.4¢b
2.5¢
8.4¢a
5.6¢
1.9¢
0¢d

County

COMPUTATION OF TAX REFUND
Note: If you are requesting a refund for more than one type of alternative fuel, attach a separate schedule showing the type of alternative fuel, tax rate,
number of gallons, and total refund claimed.
Type of Alternative Fuel                         
State Tax	
	
	 (Tax rate from Schedule II)  x  	
County Tax:
	Honolulu	
	
	 (Tax rate from Schedule II)  x  	
	Maui	
	
	 (Tax rate from Schedule II)  x  	
	Hawaii	
	
	 (Tax rate from Schedule II)  x  	
	Kauai	
	
	 (Tax rate from Schedule II)  x  	
Refund on Gallons Used Off Public Highways or for Other Exempt Purposes		

Gals.1 =  $	
Gals. = $	
Gals. = $	
Gals. = $	
Gals. = $	
$	
(Enter amount in the alternative fuel column on line 8 – Front Page)

 1 

Same as line 4, front page
Effective July 1, 2015, LNG calculation is based on the energy content of 128,714 BTU.
Effective July 1, 2015, CNG calculation is based on the energy content of 128,621 BTU.
c	
Effective July 1, 2019, Hawaii County Resolution No. 212-17 (Draft 2).
d	
Effective July 1, 2019, Biodiesel Blend is based on the energy content of 127,210 BTU and created based upon Maui County Resolution No. 19-100.
e	
Effective July 1, 2020, Maui County Resolution No. 20-82.
a	
b	

FORM M-36
(REV. 7/2020)