FORM        MARYLAND     REFUND CLAIM FORM
         MOTOR FUEL 
706                  TAX                                                          Class ______________________       Refund Status _______________
This claim is subject to audit and possible adjustment. This fuel may be          County Code ________________       Tran Status _________________
subject to sales and use tax. See instructions on page 2.
                                                                                                   DO NOT WRITE IN SHADED AREAS
                                                                                    Account Number                                     Sequence Number
SSN / IRS Number
Name (1)                                                                         Type of Refund (Check one):
                                                                                    Farm
Name (2)
                                                                                    Construction
Address (1)                                                                         Boat (Commercial purposes only)
Address (2)                                                                         Aircraft (Specify reason for exempt qualification) ____________________________
                                                                                       _______________________________________________________________
City, State, ZIP code
                                                                                    Other: _________________________________________________________
Telephone Number
                                                                                 Period of Claim
E-Mail Address                                                                   From  ___________________________  To  ___________________________

Period of Fuel Purchase            Column A                   Column B                          Column C                 Tax Per                      Column D
From ____________                  Enter Gallons              Enter Non- Refundable             Net Refundable           Gallon                       Refund Amount
                                   Purchased Each Period                 Gallons                Gallons                                (See 
To ______________        Fuel Type (Use rounded numbers) LESS (Use rounded numbers) EQUALS   (Use rounded numbers) TIMES Chart)             EQUALS
                         GAS                             -                          =                              X                        =

                         GAS                             -                          =                              X                        =

                         GAS                             -                          =                              X                        =

                         DIESEL                          -                          =                              X                        =

                         DIESEL                          -                          =                              X                        =

                         DIESEL                          -                          =                              X                        =

                         AVIATION                        -                          =                              X                    .07 =

                         TOTALS                          -                          =

CERTIFICATION: Under penalties of perjury, I declare that I have examined this return, and I hereby certify that all statements herein made are true to the best of my knowledge 
and belief, and that no part of the refund herein claimed has been heretofore paid. I further certify that the tax for which I am claiming a refund has been paid by me to the seller.

Signed: __________________________________________________________________________________ Date: ____________________________
COM/RAD-082     07/23

FORM        MARYLAND        REFUND CLAIM FORM 
706         MOTOR FUEL      INSTRUCTIONS
                 TAX

IMPORTANT:  Your claim cannot be accepted  unless  it                to a fine not exceeding $1,000 and imprisonment in the 
is prepared in accordance  with the instructions listed              county jail not exceeding six months or both.
below.                                                           (b) Fraudulent Claims: A person who fraudulently obtains 
1.  The total gallons of fuel purchased in Maryland, supported       or assists another person to fraudulently obtain a refund 
by the original invoice for each purchase, must be entered           of  motor  fuel  tax  is guilty  of  a  misdemeanor  and,  on 
in column A corresponding to the period when the fuel was            conviction,  is  subject  to  a  fine  not  exceeding  $1,000 
purchased (see invoice date).                                        or  imprisonment  in the  county  jail not  exceeding  six 
2.  Column  A  must  always  equal  the  sum  of  column  B  and     months or both.
column C for each line.                                          For more information
3.  Multiply the  amount  in  column  C  of  each  line by  the  Visit our  Web  site  at www.marylandtaxes.gov  or  call 
applicable tax per gallon. Enter this amount in column D         Taxpayer  Service  at  1-800-638-2937  or  410-260-7980  from 
for each line.                                                   Central  Maryland.  For  the  hearing impaired:  Maryland  Relay 
                                                                 Service 711.
            Effective Dates   Type               Rate
    7/1/2015 - 12/31/2015     GAS  .321                          Comptroller of Maryland
    7/1/2015 - 12/31/2015     DSL  .3285                         Revenue Administration Division
                                                                 Attn: Motor Fuel Refund Unit, Room 306B
    1/1/2016 - 6/30/2016      GAS  .3260                         110 Carroll Street
    1/1/2016 - 6/30/2016      DSL  .3335                         Annapolis, MD 21411
    7/1/2016 - 6/30/2017      GAS  .3350
    7/1/2016 - 6/30/2017      DSL  .3425
    7/1/2017 - 6/30/2018      GAS  .3380
    7/1/2017 - 6/30/2018      DSL  .3455
    7/1/2018 – 6/30/2019      GAS  .353
    7/1/2018 – 6/30/2019      DSL  .3605
    7/1/2019 – 6/30/2020      GAS  .3670
    7/1/2019 – 6/30/2020      DSL  .3745
    7/1/2020 – 6/30/2021      GAS  .3630
    7/1/2020 – 6/30/2021      DSL  .3705
    7/1/2021 – 6/30/2022      GAS  .3610
    7/1/2021 – 6/30/2022      DSL  .3685
    7/1/2022 – 6/30/2023      GAS  .4270
    7/1/2022 – 6/30/2023      DSL  .4345
    7/1/2023 – Present               GAS        .4770
    7/1/2023 – Present                  DSL        .4775

4.  Add the sum totals of columns A, B, C and D and enter on 
the TOTALS line.
5.  The sum total of column D will equal your refund.

Provisions  of  Law  Pertaining  to  Refunds  Tax  General-
Article, Title 13
§ 13-1029. Violation of motor fuel tax provisions.
A person who violates any provision of Title 9, Subtitle 3 of 
this article is guilty of a misdemeanor and, on conviction, is 
subject to a fine not exceeding $1,000 or imprisonment in 
the county jail not exceeding six months or both.
§  13-1030.  False  or  fraudulent  claims  for  refunds  of 
motor fuel tax.
(a) False claims: A person who makes or assists another 
    person to make a false claim for refund of motor fuel tax 
    is guilty of a misdemeanor and, on conviction, is subject 

COM/RAD-082      07/23