Free Form 2290 (Rev. July 2009) - Federal


File Size: 259.9 kB
Pages: 5
Date: May 18, 2009
File Format: PDF
State: Federal
Category: Tax Forms
Author: SE:W:CAR:MP
Word Count: 2,061 Words, 11,725 Characters
Page Size: 611.976 x 791.968 pts (letter)
URL

http://www.irs.gov/pub/irs-pdf/f2290.pdf

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Form (Rev. July 2009) Department of the Treasury Internal Revenue Service (99) Name

2290

Heavy Highway Vehicle Use Tax Return
For the period July 1, 2009, through June 30, 2010
Attach both copies of Schedule 1 to this return. See the separate instructions.
Employer identification number

Keep a copy of this return for your records. OMB No. 1545-0143

FOR IRS USE ONLY T FF FP I T

Type or Print
Address (number, street, and room or suite no.)

City, state, and ZIP code (For Canadian or Mexican address, see page 5 of the instructions.)

Check if applicable: Address change

Amended Return Check this box if reporting (a) additional tax from an increase in taxable gross vehicle weight or (b) suspended vehicles exceeding the mileage use limit. Do not check this box for any other reason.

VIN Correction Check this box if you are correcting a vehicle identification number (VIN) listed on a previously filed Schedule 1 (Form 2290). Do not check this box for any other reason. Final Return Check this box if you no longer have taxable vehicles to report.
Y Y Y Y M M

Part I
1

Figuring the Tax

Was the vehicle(s) reported on this return used on public highways during July 2009? If YES, enter 200907 in the boxes to the right. If NO, see the table on page 3 of the instructions . 1 2 Tax. Enter the Total from Form 2290, page 2, column (4) . . . . . . . . . . . 2 . 3 3 Additional tax from increase in taxable gross weight. See page 5 of the instructions . . . 4 4 Total tax. Add lines 2 and 3 . . . . . . . . . . . . . . . . . . . . . . 5 Credits. See page 5 of the instructions . . . . . . . . . . . . . . . . . 5 . 6 Balance due. Subtract line 5 from line 4. This is the amount you owe. If payment through EFTPS, check here . . . . . . . . . . . . . . . . . . . . . . 6 . Part II Statement in Support of Suspension (Complete the statements that apply. Attach additional sheets if needed.) 7 I declare that the vehicles listed in Part II of Schedule 1 are expected to be used on public highways (check the boxes that apply): 5,000 miles or less 7,500 miles or less for agricultural vehicles during the period July 1, 2009, through June 30, 2010, and are suspended from the tax. Complete and attach Schedule 1. 8a I declare that the vehicles listed as suspended on the Form 2290 filed for the period July 1, 2008, through June 30, 2009, were not subject to the tax for that period except for any vehicles listed on line 8b. Check this box if applicable. b Vehicle identification numbers I declare that vehicle identification numbers were listed as suspended on the Form 2290 filed for the period July 1, 2008, through June 30, 2009. These vehicles were sold or , on transferred to . At the time of the transfer, the vehicles were still eligible for the suspension of the tax. Attach a separate list if needed.
Do you want to allow another person to discuss this return with the IRS (see instructions)?
Designee's name Phone no.

9

Third Party Designee

Yes. Complete the following.
Personal identification number (PIN)

No

Sign Here Paid Preparer's Use Only

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and, to the best of my knowledge and belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

Signature Type or print name below signature. Preparer's signature Firm's name (or yours if self-employed), address, and ZIP code Date

Date Telephone number Check if selfemployed EIN Phone no. Cat. No. 11250O Form Preparer's SSN or PTIN

For Privacy Act and Paperwork Reduction Act Notice, see page 9 of the instructions.

2290 (Rev. 7-2009)

Form 2290 (Rev. 7-2009)

Page 2

Tax Computation
(1) Annual tax (vehicles used during July) (a) Vehicles Except Logging* (b) Logging Vehicles* (2) Partial-period tax (vehicles first used after July) (See the tables on page 10 of the instructions.) (a) Vehicles Except Logging* (b) Logging Vehicles* (3) Number of vehicles (4) Amount of tax (col. (1) or (2) times col. (3))

Category

Taxable Gross Weight (in pounds)

(a) Vehicles Except Logging*

(b) Logging Vehicles*

A B C D E F G H I J K L M N O P Q R S T U V

55,000 55,001 56,000 56,001 57,000 57,001 58,000 58,001 59,000 59,001 60,000 60,001 61,000 61,001 62,000 62,001 63,000 63,001 64,000 64,001 65,000 65,001 66,000 66,001 67,000 67,001 68,000 68,001 69,000 69,001 70,000 70,001 71,000 71,001 72,000 72,001 73,000 73,001 74,000 74,001 75,000 Over 75,000

$100.00 122.00 144.00 166.00 188.00 210.00 232.00 254.00 276.00 298.00 320.00 342.00 364.00 386.00 408.00 430.00 452.00 474.00 496.00 518.00 540.00 550.00

$75.00 $ 91.50 108.00 124.50 141.00 157.50 174.00 190.50 207.00 223.50 240.00 256.50 273.00 289.50 306.00 322.50 339.00 355.50 372.00 388.50 405.00 412.50

$

$

Totals. Add the number of vehicles in columns (3a) and (3b). Enter the total here and on Schedule 1, Part III, line a. Add the amounts in column (4). Enter the total here and on Form 2290, line 2 . . . . . . . . . . . . . . . . .

W

Tax-Suspended Vehicles (See Part II on page 6 of the instructions.)

$

Complete both copies of Schedule 1 (Form 2290) and attach them to Form 2290.
* See page 2 of the instructions for information on logging vehicles. Form

2290 (Rev. 7-2009)

Category

A B C D E F G H I J K L M N O P Q R S T U V

SCHEDULE 1 (Form 2290)

Schedule of Heavy Highway Vehicles
For the period July 1, 2009, through June 30, 2010
OMB No. 1545-0143

(Rev. July 2009) Complete both copies of Schedule 1 and attach them to Form 2290. Department of the Treasury See the Consent to Disclosure of Tax Information on page 2. Internal Revenue Service Name as shown on Form 2290 Employer identification number

Type or Print
Address (number, street, and room or suite no.)

FOR IRS USE ONLY T FF FP I T Category

City, state, and ZIP code (For Canadian or Mexican address, see page 5 of the instructions.)

Caution. You must list all vehicles. Attach a separate list if needed. See page 7 of the instructions.

Part I
1 2 3 4 5

Vehicles on Which You Are Reporting Tax. Enter VIN and category.

Part II
1 2

Vehicles for Which Tax Is Suspended--5,000 Miles or Less (7,500 Miles or Less for Agricultural Vehicles). Enter VIN.

Category

W W

Part III

Summary of Reported Vehicles
a b

a Enter the number of taxable vehicles from Form 2290, page 2, column 3, Totals . . . . . . . . . . . b Enter the total number of taxable vehicles on which the tax is suspended from Form 2290, page 2, column 3 (category W)
For Privacy Act and Paperwork Reduction Act Notice, see page 9 of the instructions. Do not cut or separate the forms on this page.

Schedule 1 (Form 2290) (Rev. 7-2009)

SCHEDULE 1 (Form 2290)

Schedule of Heavy Highway Vehicles
For the period July 1, 2009, through June 30, 2010
OMB No. 1545-0143

(Rev. July 2009) This copy will be stamped and returned to you for use as proof of payment when registering Department of the Treasury vehicle(s) with a state. Internal Revenue Service Name as shown on Form 2290 Employer identification number

Type or Print
Address (number, street, and room or suite no.)

City, state, and ZIP code (For Canadian or Mexican address, see page 5 of the instructions.)

Caution. You must list all vehicles. Attach a separate list if needed. See page 7 of the instructions.

Part I
1 2 3 4 5

Vehicles on Which You Are Reporting Tax. Enter VIN and category.

Category

Part II
1 2

Vehicles for Which Tax Is Suspended--5,000 Miles or Less (7,500 Miles or Less for Agricultural Vehicles). Enter VIN.

Category

W W

Part III

Summary of Reported Vehicles
a b

a Enter the number of taxable vehicles from Form 2290, page 2, column 3, Totals . . . . . . . . . . . b Enter the total number of taxable vehicles on which the tax is suspended from Form 2290, page 2, column 3 (category W)
For Privacy Act and Paperwork Reduction Act Notice, see page 9 of the instructions.
Cat. No. 11250O

Schedule 1 (Form 2290) (Rev. 7-2009)

Schedule 1 (Form 2290) (Rev. 7-2009)

Page 2

Consent to Disclosure of Tax Information
For the period July 1, 2009, through June 30, 2010 By signing, dating, and entering my employer identification number below, I hereby consent to the Internal Revenue Service (IRS) disclosing information about my payment of the Heavy Highway Vehicle Use Tax (HVUT) for the tax period listed above to the federal Department of Transportation (DOT), U.S. Customs and Border Protection (CBP), and to state Departments of Motor Vehicles (DMV). The information disclosed to the DOT, CBP, and state DMVs will be my Vehicle Identification Number (VIN) and verification that I have paid the HVUT. The IRS may disclose the information to the DOT, CBP, and to the DMVs of the 50 states and the District of Columbia who have other taxing, registration, or information collecting authority. I understand that the information to be disclosed is generally confidential under the laws applicable to the IRS and that the agency receiving the HVUT information is not bound by these laws and may use the information for any purpose as permitted by other federal laws and/or state law. To be effective, this consent must be submitted to the IRS within 60 days of the date below. If signed by a corporate officer or party other than the taxpayer, I certify that I have the authority to execute this consent to disclosure of tax information. Sign Here

Signature Type or print name below signature.

Date Employer identification number
Schedule 1 (Form 2290) (Rev. 7-2009)

Form 2290-V, Payment Voucher
Purpose of Form
Complete Form 2290-V if you are making a payment by check or money order with Form 2290, Heavy Highway Vehicle Use Tax Return. We will use Form 2290-V to credit your payment more promptly and accurately, and to improve our service to you. If you have your return prepared by a third party and a payment is required, provide Form 2290-V to the return preparer. Do not file Form 2290-V if you are paying the balance due on line 6 of Form 2290 using EFTPS or electronic funds withdrawal (direct debit). Box 2. Enter the amount paid from line 6 of Form 2290. Box 3. Enter the date as shown on line 1 of Form 2290. Box 4. Enter your name and address as shown on Form 2290. Enclose your check or money order made payable to the "United States Treasury." Be sure to enter your EIN, "Form 2290," and the tax period on your check or money order. Do not send cash. Do not staple Form 2290-V or your payment to Form 2290 (or to each other). Detach Form 2290-V and send it with your payment and Form 2290. See Where to file on page 3 of the instructions for Form 2290.

Specific Instructions
Box 1. If you do not have an EIN, you may apply for one online. Go to the IRS website at www.irs.gov/businesses/small and click on the "Employer ID Numbers (EIN)" link. You may also apply for an EIN by calling 1-800-829-4933, or you can fax or mail Form SS-4, Application for Employer Identification Number, to the IRS.

Detach here

(Rev. July 2009) Department of the Treasury Internal Revenue Service 1 Employer identification number

2290-V

Form

Payment Voucher
For the period July 1, 2009, through June 30, 2010 See How To Make Your Payment on page 7 of the instructions. Do not staple or attach this voucher or your payment to your return.
2 Dollars OMB No. 1545-0143 Cents

Enter the amount of your payment.
3 Enter date as shown on line 1 of Form 2290. 4 Name Address Send Form 2290, this voucher, and payment to: Internal Revenue Service P.O. Box 804525 Cincinnati, OH 45280-4525 City, state, and ZIP code (For Canadian or Mexican address, see instructions.)

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Y

Y

Y

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