N.H. Code Admin. R. Saf-C 311.32 - Form RT 127D, Road Toll Refund Application - Private School Bus Owner - Toll Paid on Special Fuel

(a) An applicant shall submit the following on form RT 127D:
(1) Applicant's name, address and telephone number;
(2) Federal employer identification number, if applicable;
(3) List of contracted school districts;
(4) Period covered by month and year;
(5) Applicant's claim, including:
a. Total gallons per invoice;
b. Total miles used to transport contracted school districts' students;
c. Total gallons used to transport contracted school district's students;
d. Miles per gallon; and
e. Dollar amount of refund requested;
(6) Vehicle listing;
(7) Make and year of vehicle;
(8) Registration number;
(9) Itemized gallons used as assessed;
(10) Itemized gallons used as non-assessed;
(11) Total gallons used as assessed;
(12) Total gallons used as non-assessed;
(13) Grand total, assessed and non-assessed; and
(14) Stock record, including:
a. Actual inventory;
b. Total gallons per invoice;
c. Total gallons to be accounted for;
d. Total gallons used;
e. Total gallons sold;
f. Book inventory on the last day of the period;
g. Actual inventory on the last day of the period;
h. Stock loss or gain; and
i. Total gallons accounted for.
(b) The applicant shall print his/her title and sign the form.


N.H. Code Admin. R. Saf-C 311.32

(See Revision Notes #1 and #2 at chapter heading for Saf-C 300) #10032, eff 11-22-11

Renumbered From Saf-C 311.30 Volume XXXV Number 1, Filed January 8, 2015, Proposed by #10753, Effective 1/1/2015.

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