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                                       Quarterly Federal Excise Tax Return
Form 720                                                                                                                   OMB No. 1545-0023
(Rev. December 2022)                                 See the Instructions for Form 720.
Department of the Treasury             Go to www.irs.gov/Form720 for instructions and the latest information.
Internal Revenue Service 
                         Name                                            Quarter ending                                 FOR IRS USE ONLY 
Check here if: 
Final return                                                                                                            T 
                         Number, street, and room or suite no.           Employer identification number 
Address change           (If you have a P.O. box, see the instructions.)                                                FF 
                                                                                                                        FD 
                                                                                                                        FP 
                         City or town, state or province, country, and ZIP or foreign postal code                       I 
                                                                                                                        T 

Part I 
IRS No. Environmental Taxes (attach Form 6627, ODCs are ozone-depleting chemicals)                                         Tax    IRS No. 
18      Domestic petroleum oil spill tax                                                                                          18
21      Imported petroleum products oil spill tax                                                                                 21
54      Chemicals (other than ODCs)                                                                                               54
17      Imported chemical substances                                                                                              17
98      ODCs                                                                                                                      98 
19      ODC tax on imported products                                                                                              19 
        Communications and Air Transportation Taxes (see instructions)                                                     Tax         
22      Local telephone service and teletypewriter exchange service                                                               22 
26      Transportation of persons by air                                                                                          26 
28      Transportation of property by air                                                                                         28 
27      Use of international air travel facilities                                                                                27 
        Fuel Taxes                                                                  Number of gallons   Rate               Tax         
        (a)  Diesel, tax on removal at terminal rack                                                  $.244
60      (b)  Diesel, tax on taxable events other than removal at terminal rack                          .244                      60 
        (c)  Diesel, tax on sale or removal of biodiesel mixture 
                (not at terminal rack)                                                                  .244          }
104  Diesel-water fuel emulsion                                                                         .198                      104 
105  Dyed diesel, LUST tax                                                                              .001                      105 
107  Dyed kerosene, LUST tax                                                                            .001                      107 
119  LUST tax, other exempt removals (see instructions)                                                 .001                      119 
35      (a)  Kerosene, tax on removal at terminal rack (see instructions)                               .244
        (b)  Kerosene, tax on taxable events other than removal at terminal rack                        .244          }           35 
69      Kerosene for use in aviation (see instructions)                                                 .219                      69 
77      Kerosene for use in commercial aviation (other than foreign trade)                              .044                      77 
111  Kerosene for use in aviation, LUST tax on nontaxable uses                                          .001                      111 
79      Other fuels (see instructions)                                                                                            79 
62      (a)  Gasoline, tax on removal at terminal rack                                                  .184
           (b)  Gasoline, tax on taxable events other than removal at terminal rack                     .184          }           62 
13      Any liquid fuel used in a fractional ownership program aircraft                                 .141                      13
14      Aviation gasoline                                                                               .194                      14 
112  Liquefied petroleum gas (LPG) (see instructions)                                                   .183                      112 
118  “P Series” fuels                                                                                   .184                      118 
120  Compressed natural gas (CNG) (see instructions)                                                    .183                      120 
121  Liquefied hydrogen                                                                                 .184                      121 
122     Fischer-Tropsch process liquid fuel from coal (including peat)                                  .244                      122 
123  Liquid fuel derived from biomass                                                                   .244                      123 
124  Liquefied natural gas (LNG) (see instructions)                                                     .243                      124 
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.                    Cat. No. 10175Y     Form 720 (Rev. 12-2022)

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Form 720 (Rev. 12-2022) Page 2
IRS No. Rate Tax IRS No.
33 Retail Tax—Truck, trailer, and semitrailer chassis and bodies, and tractor 12% of sales price 33
Ship Passenger Tax Number of persons Rate Tax
29 Transportation by water $3 per person 29
Other Excise Tax Amount of obligations Rate Tax
31 Obligations not in registered form $.01 31
Foreign Insurance Taxes—Policies issued by foreign insurers Premiums paid Rate Tax IRS No.
Casualty insurance and indemnity bonds $.04
30 Life insurance, sickness and accident policies, and annuity
contracts .01 30
Reinsurance .01 }
Manufacturers Taxes Number of tons Sales price
36 $1.10 per ton 36
37
Coal—Underground mined 4.4% of sales price 37
38 $.55 per ton 38
39
Coal—Surface mined 4.4% of sales price 39
Number of tires Tax IRS No.
108 Taxable tires other than bias ply or super single tires 108
109 Taxable bias ply or super single tires (other than super single tires designed for steering) 109
113 Taxable tires, super single tires designed for steering 113
40 Gas guzzler tax. Attach Form 6197. Check if one-time filing . . . . . . . . . . . . 40
97 Vaccines (see instructions) 97
Sales price
Reserved for future use 2.3% of sales price
1 Total. Add all amounts in Part I. Complete Schedule A unless one-time filing. . . . . . . . $
Part II
Patient-Centered Outcomes Research Fee (see (a) Avg. number (b) Rate for
of lives covered avg. (c) Fee (see
IRS No. instructions) (see inst.) covered life instructions) Tax IRS No.
Specified health insurance policies
(a) With a policy year ending before October 1, 2021 $2.66
(b) With a policy year ending on or after October 1, 2021,
and before October 1, 2022 $2.79
133 Applicable self-insured health plans 133
(c) With a plan year ending before October 1, 2021 $2.66
(d) With a plan year ending on or after October 1, 2021,
and before October 1, 2022 $2.79 }
Rate Tax
41 Sport fishing equipment (other than fishing rods and fishing poles) 10% of sales price 41
110 Fishing rods and fishing poles (limits apply, see instructions) 10% of sales price 110
42 Electric outboard motors 3% of sales price 42
114 Fishing tackle boxes 3% of sales price 114
44 Bows, quivers, broadheads, and points 11% of sales price 44
106 Arrow shafts $.55 per shaft 106
140 Indoor tanning services 10% of amount paid 140
Number of gallons Rate Tax
64 Inland waterways fuel use tax $.29 64
125 LUST tax on inland waterways fuel use (see instructions) .001 125
51 Section 40 fuels (see instructions) 51
117 Biodiesel sold as but not used as fuel 117
20 Floor Stocks Tax—Ozone-depleting chemicals (floor stocks). Attach Form 6627. 20
2 Total. Add all amounts in Part II . . . . . . . . . . . . . . . . . . . . . . $
Form 720 (Rev. 12-2022)

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Form 720 (Rev. 12-2022)                                                                                                                                               Page 3 
Part III 
3    Total tax. Add Part I, line 1, and Part II, line 2  . . . . .         . . . .  . .                 . . .  .     . . .       3 
4    Claims (see instructions; complete Schedule C)  .       . . .         . . . .    4 
5    Deposits made for the quarter  .           . . . .    5 
         Check here if you used the safe harbor rule to make your deposits. 
6    Overpayment from previous quarters .           . .    6 
7    Enter the amount from Form 720-X included 
     on line 6, if any  .  . . .       . .      . . . .    7 
8    Add lines 5 and 6  .    . .       . .      . . . .  . . . . .         . . . .    8 
9    Add lines 4 and 8  .    . .       . .      . . . .  . . . . .         . . . .  . .                 . . .  .     . . .       9 
10   Balance Due. If line 3 is greater than line 9, enter the difference. Pay the full amount with the return (see instructions) 10 
11   Overpayment. If line 9 is greater than line 3, enter the difference. Check if you want the 
     overpayment:          Applied to your next return, or       Refunded to you.                                                11 
Third Party Do you want to allow another person to discuss this return with the IRS (see instructions)?                  Yes. Complete the following.                 No 
Designee    Designee name                                      Phone  no.                                   Personal identification number (PIN) 
            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, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. 
Sign  
Here        Signature                                                          Date                            Title 
            Type or print name below signature.                                                                Telephone number 
            Print/Type preparer’s name                Preparer’s signature                                Date                            PTIN
Paid                                                                                                                     Check         if 
                                                                                                                         self-employed
Preparer 
            Firm’s name                                                                                              Firm’s EIN 
Use Only    Firm’s address                                                                                           Phone no.
                                                                                                                                    Form 720 (Rev. 12-2022)

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Form 720 (Rev. 12-2022)                                                                            Page 4 
Schedule A   Excise Tax Liability (see instructions) 

Note: You must complete Schedule A if you have a liability for any tax in Part I of Form 720. Don’t complete Schedule A for 
Part II taxes or for a one-time filing of the gas guzzler tax. 

1 Regular method taxes 
  (a)  Record of Net                                           Period 
      Tax Liability                         1st–15th day                 16th–last day 
  First month                   A                                   B 
  Second month                  C                                   D 
  Third month                   E                                   F 
  Special rule for September *  .         . . .     . . . . .  .    G 

  (b) Net liability for regular method taxes. Add the amounts for each semimonthly period. 

2 Alternative method taxes (IRS Nos. 22, 26, 28, and 27) 
  (a)  Record of Taxes                                         Period 
      Considered as  
                                            1st–15th day                 16th–last day 
      Collected                                                          
  First month                   M                                   N
  Second month                  O                                   P
  Third month                   Q                                   R
  Special rule for September *   .        . . .     . . . . .  .    S

  (b) Alternative method taxes. Add the amounts for each semimonthly period.
  *Complete  only as instructed (see instructions). 

Schedule T   Two-Party Exchange Information Reporting (see instructions) 
Fuel                                                                                       Number of gallons 
Diesel fuel, gallons received in a two-party exchange within a terminal, included  
on Form 720, IRS No. 60(a) 
Diesel fuel, gallons delivered in a two-party exchange within a terminal 
Kerosene, gallons received in a two-party exchange within a terminal, included 
on Form 720, IRS No. 35(a), 69, 77, or 111 
Kerosene, gallons delivered in a two-party exchange within a terminal 
Gasoline, gallons received in a two-party exchange within a terminal, included 
on Form 720, IRS No. 62(a) 
Gasoline, gallons delivered in a two-party exchange within a terminal 
Aviation gasoline, gallons received in a two-party exchange within a terminal, included 
on Form 720, IRS No. 14 
Aviation gasoline, gallons delivered in a two-party exchange within a terminal 
                                                                                           Form 720 (Rev. 12-2022)

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Form 720 (Rev. 12-2022) Page 5
Schedule C Claims Month your income tax year ends
• Complete Schedule C for claims only if you are reporting liability in Part I or II of Form 720.
• Attach a statement explaining each claim as required. Include your name and EIN on the statement (see instructions).
Caution: Claimant has the name and address of the person(s) who sold the fuel to the claimant, the dates of purchase, and if
exported, the required proof of export. For claims on lines 1a and 2b (type of use 13 and 14), 3c, 4b, and 5, claimant hasn’t waived
the right to make the claim.
1 Nontaxable Use of Gasoline Note: CRN is credit reference number. Period of claim
Type of use Rate Gallons Amount of claim CRN
a Gasoline (see Caution above line 1) $.183 $ 362
b Exported (see Caution above line 1) .184 411
2 Nontaxable Use of Aviation Gasoline Period of claim
Type of use Rate Gallons Amount of claim CRN
a Used in commercial aviation (other than foreign trade) $.15 $ 354
b Other nontaxable use (see Caution above line 1) .193 324
c Exported (see Caution above line 1) .194 412
d LUST tax on aviation fuels used in foreign trade .001 433
3 Nontaxable Use of Undyed Diesel Fuel Period of claim
Claimant certifies that the diesel fuel did not contain visible evidence of dye.
Exception. If any of the diesel fuel included in this claim did contain visible evidence of dye, attach a detailed
explanation and check here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Type of use Rate Gallons Amount of claim CRN
a Nontaxable use $.243 $ 360
b Use in trains .243 353
c Use in certain intercity and local buses (see Caution above line 1) .17 350
d Use on a farm for farming purposes .243 360
e Exported (see Caution above line 1) .244 413
4 Nontaxable Use of Undyed Kerosene (Other Than Kerosene Used in Aviation) Period of claim
Claimant certifies that the kerosene did not contain visible evidence of dye.
Exception. If any of the kerosene included in this claim did contain visible evidence of dye, attach a detailed
explanation and check here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Caution: Claims cannot be made on line 4 for kerosene sales from a blocked pump. Type of use Rate Gallons Amount of claim CRN
a Nontaxable use $.243 $ 346
b Use in certain intercity and local buses (see Caution above line 1) .17 347
c Use on a farm for farming purposes .243 346
d Exported (see Caution above line 1) .244 414
e Nontaxable use taxed at $.044 .043 377
f Nontaxable use taxed at $.219 .218 369
5 Kerosene Used in Aviation (see Caution above line 1) Period of claim
Type of use Rate Gallons Amount of claim CRN
a Kerosene used in commercial aviation (other than foreign
trade) taxed at $.244 $.200 $ 417
b Kerosene used in commercial aviation (other than foreign
trade) taxed at $.219 .175 355
c Nontaxable use (other than use by state or local
government) taxed at $.244 .243 346
d Nontaxable use (other than use by state or local
government) taxed at $.219 .218 369
e LUST tax on aviation fuels used in foreign trade .001 433
Form 720 (Rev. 12-2022)

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Form 720 (Rev. 12-2022) Page 6
6 Nontaxable Use of Alternative Fuel
Caution: There is a reduced credit rate for use in certain intercity and local buses (type of use 5) (see instructions).
Gallons, or gasoline
Type of use Rate or diesel gallon Amount of claim CRN
equivalents
a Liquefied petroleum gas (LPG) (see instructions) $.183 $ 419
b “P Series” fuels .183 420
c Compressed natural gas (CNG) (see instructions) .183 421
d Liquefied hydrogen .183 422
e Fischer-Tropsch process liquid fuel from coal (including peat) .243 423
f Liquid fuel derived from biomass .243 424
g Liquefied natural gas (LNG) (see instructions) .243 425
h Liquefied gas derived from biomass .183 435
7 Sales by Registered Ultimate Vendors of Undyed Diesel Fuel Period of claim
Registration number
Claimant certifies that it sold the diesel fuel at a tax-excluded price, repaid the amount of tax to the buyer, or has obtained
written consent of the buyer to make the claim. Claimant certifies that the diesel fuel didn’t contain visible evidence of dye.
Exception. If any of the diesel fuel included in this claim did contain visible evidence of dye, attach a detailed
explanation and check here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rate Gallons Amount of claim CRN
a Use by a state or local government $.243 $ 360
b Use in certain intercity and local buses .17 350
8 Sales by Registered Ultimate Vendors of Undyed Kerosene Period of claim
(Other Than Kerosene For Use in Aviation) Registration number
Claimant certifies that it sold the kerosene at a tax-excluded price, repaid the amount of tax to the buyer, or has obtained the
written consent of the buyer to make the claim. Claimant certifies that the kerosene didn’t contain visible evidence of dye.
Exception. If any of the kerosene included in this claim did contain visible evidence of dye, attach a detailed
explanation and check here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rate Gallons Amount of claim CRN
a Use by a state or local government $.243 $
346
b Sales from a blocked pump .243
c Use in certain intercity and local buses .17 347
9 Sales by Registered Ultimate Vendors of Kerosene For Use in Aviation Registration number
• See Caution above line 1.
• Claimant sold the kerosene for use in aviation at a tax-excluded price and hasn’t collected the amount of tax from the buyer,
repaid the amount of tax to the buyer, or has obtained written consent of the buyer to make the claim. See the instructions for
additional information to be submitted.
Type of use Rate Gallons Amount of claim CRN
a Use in commercial aviation (other than foreign trade) taxed at $.219 $.175 $ 355
b Use in commercial aviation (other than foreign trade) taxed at $.244 .200 417
c Nonexempt use in noncommercial aviation .025 418
d Other nontaxable uses taxed at $.244 .243 346
e Other nontaxable uses taxed at $.219 .218 369
f LUST tax on aviation fuels used in foreign trade .001 433
10 Sales by Registered Ultimate Vendors of Gasoline Registration number
Claimant sold the gasoline at a tax-excluded price and hasn’t collected the amount of tax from the buyer, repaid the amount of
tax to the buyer, or has obtained written consent of the buyer to take the claim; and obtained an unexpired certificate from the
buyer and has no reason to believe any information in the certificate is false. See the instructions for additional information to
be submitted.
Rate Gallons Amount of claim CRN
a Use by a nonprofit educational organization $.183 $
362
b Use by a state or local government .183
Form 720 (Rev. 12-2022)

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Form 720 (Rev. 12-2022)                                                                                                                                Page 7 
11    Sales by Registered Ultimate Vendors of Aviation Gasoline                  Registration number
      Claimant sold the aviation gasoline at a tax-excluded price and hasn’t collected the amount of tax from the buyer, repaid the amount 
      of tax to the buyer, or has obtained written consent of the buyer to take the claim; and obtained an unexpired certificate from the buyer 
      and has no reason to believe any information in the certificate is false. See the instructions for additional information to be submitted. 
                                                                               Rate                       Gallons                Amount of claim       CRN 
    a Use by a nonprofit educational organization                              $.193                                           $ 
                                                                                                                                                       324
    b Use by a state or local government                                       .193
12    Biodiesel or Renewable Diesel Mixture Credit Period of claim                                        Registration number 
      Biodiesel  mixtures. Claimant  produced  a  mixture  by  mixing  biodiesel  with  diesel  fuel.  The  biodiesel  used  to  produce  the
      mixture met ASTM D6751 and met EPA’s registration requirements for fuels and fuel additives. The mixture was sold by the
      claimant  to  any  person  for  use  as  a  fuel  or  was  used  as  a  fuel  by  the  claimant.  Claimant  has  attached  the  Certificate  for 
      Biodiesel and, if applicable, the Statement of Biodiesel Reseller. Renewable diesel mixtures. Claimant produced a mixture by
      mixing renewable diesel with liquid fuel (other than renewable diesel). The renewable diesel used to produce the renewable 
      diesel  mixture  was  derived  from  biomass,  met  EPA’s  registration  requirements  for  fuels  and  fuel  additives,  and  met  ASTM 
      D975, D396, or other equivalent standard approved by the IRS. The mixture was sold by the claimant to any person for use as 
      a fuel or was used as a fuel by the claimant. Claimant has attached the Certificate for Biodiesel and, if applicable, Statement of
      Biodiesel Reseller, both of which have been edited as discussed in the instructions for line 12. See the instructions for line 12 
      for information about renewable diesel used in aviation.

                                                                               Rate                       Gal. of biodiesel or   Amount of claim       CRN 
                                                                                                          renewable diesel 

    a Biodiesel (other than agri-biodiesel) mixtures                           $1.00                                           $                       388
    b Agri-biodiesel mixtures                                                  1.00                                                                    390
    c Renewable diesel mixtures                                                1.00                                                                    307
13    Alternative Fuel Credit and Alternative Fuel Mixture Credit                                         Registration number 
      For the alternative fuel mixture credit, claimant produced a mixture by mixing taxable fuel with alternative fuel. Claimant certifies that 
      it (a) produced the alternative fuel, or (b) has in its possession the name, address, and EIN of the person(s) that sold the alternative 
      fuel to the claimant; the date of purchase; and an invoice or other documentation identifying the amount of the alternative fuel. The 
      claimant also certifies that it made no other claim for the amount of the alternative fuel, or has repaid the amount to the government. 
      The alternative fuel mixture was sold by the claimant to any person for use as a fuel or was used as a fuel by the claimant.
                                                                                                          Gallons, or  
                                                                               Rate                       gasoline or diesel     Amount of claim       CRN 
                                                                                                          gallon equivalents 
                                                                                                          (see instructions) 
    a Liquefied petroleum gas (LPG)* (see instructions)                        $.50                                            $                       426
    b “P Series” fuels                                                         .50                                                                     427
    c Compressed natural gas (CNG)* (see instructions)                         .50                                                                     428
    d Liquefied hydrogen                                                       .50                                                                     429
    e Fischer-Tropsch process liquid fuel from coal (including peat)           .50                                                                     430
    f Liquid fuel derived from biomass                                         .50                                                                     431
    g Liquefied natural gas (LNG)* (see instructions)                          .50                                                                     432
    h Liquefied gas derived from biomass*                                      .50                                                                     436
    i Compressed gas derived from biomass*                                     .50                                                                     437
      * You can’t claim the alternative fuel mixture credit for this fuel.
14    Other claims.See the instructions. For lines 14b and 14c, see theCaution above line 1 on page 5.                           Amount of claim       CRN 
    a Section 4051(d) tire credit (tax on vehicle reported on IRS No. 33)                                                      $                       366
    b Exported dyed diesel fuel and exported gasoline blendstocks taxed at $.001                                                                       415
    c Exported dyed kerosene                                                                                                                           416
    d Diesel-water fuel emulsion 
    e Registered credit card issuers 
                                                                                                          Number of tires        Amount of claim       CRN 
    f Taxable tires other than bias ply or super single tires                                                                  $                       396
    g Taxable tires, bias ply or super single tires (other than super single tires designed for steering)                                              304
    h Taxable tires, super single tires designed for steering                                                                                          305
    i Chemicals (other than ODCs)                                                                                                                      454
    j Imported chemical substances                                                                                                                     317
    k
15    Total claims. Add amounts on lines 1 through 14. Enter the result here and on Form 720, Part III, line 4.   15 
                                                                                                                                 Form 720 (Rev. 12-2022)

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Form 720-V,
Payment Voucher

Purpose of Form Box 2. Enter the amount paid from line 10 of Form 720.
Complete Form 720-V if you’re making a payment by Box 3. Darken the circle identifying the quarter for which
check or money order with Form 720, Quarterly the payment is made. Darken only one circle.
Federal Excise Tax Return. We will use the completed Box 4. Enter your name and address as shown on
voucher to credit your payment more promptly and Form 720.
accurately, and to improve our service to you.
• Enclose your check or money order made payable to
If you have your return prepared by a third party and a “United States Treasury.” Be sure to enter your
payment is required, provide this payment voucher to EIN (SSN for one-time filing), “Form 720,” and the tax
the return preparer. period on your check or money order. Don’t send cash.
Don’t file Form 720-V if you’re paying the balance Don’t staple this voucher or your payment to the return
due on line 10 of Form 720 using EFTPS. (or to each other).
• Detach the completed voucher and send it with your
Specific Instructions payment and Form 720. See Where To File in the
Box 1. If you don’t have an EIN, you may apply for Instructions for Form 720.
one online by visiting www.irs.gov/EIN. You may also
apply for an EIN by faxing or mailing Form SS-4,
Application for Employer Identification Number, to the
IRS. However, if you’re making a one-time filing, enter
your social security number.

Form 720-V (2022)
Detach here and mail with your payment and Form 720.

OMB No. 1545-0023
Form Payment Voucher
Department720-Vof the Treasury Don’t staple or attach this voucher to your payment.
Internal Revenue Service 2022
1 Enter your employer identification 2 Dollars Cents
number (EIN). See instructions.
Enter the amount of your payment.
Make your check or money order payable to “United States Treasury.”
3 Tax Period 4 Enter your business name (individual name if sole proprietor).
1st 3rd
Quarter Quarter Enter your address.

2nd 4th City or town, state or province, country, and ZIP or foreign postal code
Quarter Quarter

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