Free TC-937, Utah IFTA Renewal Application and Decal Request - Utah

Clear form
93781

TC-937 Utah IFTA Renewal Application and Decal Request Rev. 10/08

Utah State Tax Commission

9998
Name and address

Business name

Telephone no. IRP number U.S. DOT number Year

CANCEL IFTA License (Cancel date: ____________) If you have ceased operations, check "CANCEL IFTA License" IFTA account number and enter the cancel date and provide explanation on back. UT-

Utah State Tax Commission IFTA Renewal 210 N 1950 W SLC UT 84134-8135

Enter the calendar year (Jan - Dec) for which you are renewing. 1. Enter the number of decal sets needed 2. Price per decal set 3. Total amount due (multiply line 1 by line 2)

$4.00
$

Corrections/Explanations

Applicant agrees to comply with reporting, payment, record keeping, and license display requirements as specified in the International Fuel Tax Agreement. The applicant further agrees that the base jurisdiction may withhold refunds due if applicant is delinquent on payment of fuel taxes due any member jurisdiction. Failure to comply with these requirements shall be grounds for revocation of license in all member jurisdictions. Applicant certifies that to the best of his or her knowledge, the information is true, accurate, and complete and any falsification subjects him or her to appropriate civil and/or criminal sanction of the base jurisdiction. Applicant's signature X
Detach here and submit coupon

Date signed

TC-937PC Rev. 10/08

Payment Coupon for IFTA Renewal/Decal Request, TC-937PC
IFTA Account Number Period Ending mmddyyyy Due Date mmddyyyy

Tax Type

IFTA

UT-

I F T A
00

UTAH STATE TAX COMMISSION 210 N 1950 W SLC UT 84134-0520

Amount Paid

Make check or money order payable to the Utah State Tax Commission. Do not send cash. Do not staple check to this coupon. Detach stub from check.

90000

Renewal Application Complete and return the entire renewal application to renew your IFTA license and decals. Return with payment within 10 days. Account will not be renewed unless all returns are filed and paid in full. Enter the number of decal sets needed for the company identified on this IFTA renewal. Base the number of decal sets on the number of units owned or leased by this company and that will be accounted for on this company's IFTA return. These IFTA decals may only be used on units reported on this company's IFTA return. Additional decals purchased must be tied to additional units purchased or leased by this company or used to replace unusable decals. Additional decals can be requested on form TC-934. Federal ID (FEIN/EIN): Use the federal ID number assigned by the federal government. This number is the IFTA/Special Fuel User License number. Due to privacy issues, we discourage the use of Social Security Numbers. Changes - Incorrect Information or Business Name or Ownership Changes If there is a business name change or if the information is incorrect, make the corrections above. If there is an ownership change, you must complete a new application, TC-69MC. Changes - Address and Telephone If there is an address or telephone number change, make the corrections above.

IFTA License When you receive your new IFTA license it will show the mailing address and business address listed on our IFTA account file. A copy of the license must be kept in the cab of each IFTA-qualified vehicle. IFTA Decals Display Each IFTA-qualified vehicle is required to display two decals, one on each side of the vehicle cab. IFTA Fee Requirement A fee of $4 per set of decals (2 decals) is required. Please enclose a check for the total amount due. Make your check payable to the Utah State Tax Commission and return with this form. NOTE: If you have any questions about your IFTA renewal or need forms, contact the Tax Commission by calling (801) 297-6800 or toll-free 1-888-251-9555 or access the Tax Commission's web site at motorcarrier.utah.gov. If you need an accommodation under the Americans with Disabilities Act, contact the Tax Commission at (801) 2973811 or Telecommunication Device for the Deaf (TDD) (801) 297-2020. Please allow three working days for a response. Signature is required on front. Application will be rejected without the signature.

Please Note: If you travel in Utah only, your account will be changed to Special Fuel User (SFU). You will be sent a permit for SFU and requested decals.