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.

Notes

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.