OMB No. 1545-0162
Form 4136                                 Credit for Federal Tax Paid on Fuels

Department of the Treasury     Go to www.irs.gov/Form4136 for instructions and the latest information.            Attachment 2022
Internal Revenue Service                                                                                          Sequence No. 23
Name (as shown on your income tax return)                                                                         Taxpayer identification number

     Caution: Claimant has the name and address of the person who sold the fuel to the claimant and the dates of purchase. For 
                  claims on lines 1c and 2b (type of use 13 or 14), 3d, 4c, and 5, claimant has not waived the right to make the claim. 
                  For claims on lines 1c and 2b (type of use 13 or 14), claimant certifies that a certificate has not been provided to the
                  credit card issuer. 
1    Nontaxable Use of Gasoline                                                               Note: CRN is the credit reference number.

                                                                 (a) Type of use    (b) Rate  (c) Gallons        (d) Amount of credit      (e) CRN
a    Off-highway business use                                                          $ .183                                                    
b    Use on a farm for farming purposes                                                .183                                                  362
c    Other nontaxable use (see Caution above line 1)                                   .183                   } $
d    Exported                                                                          .184                                                  411
2    Nontaxable Use of Aviation Gasoline

                                                                 (a) Type of use    (b) Rate  (c) Gallons        (d) Amount of credit      (e) CRN
a    Use in commercial aviation (other than foreign trade)                             $ .15                    $                            354
b    Other nontaxable use (see Caution above line 1)                                   .193                                                  324
c    Exported                                                                          .194                                                  412
d    LUST tax on aviation fuels used in foreign trade                                  .001                                                  433
3    Nontaxable Use of Undyed Diesel Fuel
     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 an explanation and check here . .
                                                                 (a) Type of use    (b) Rate  (c) Gallons        (d) Amount of credit      (e) CRN
a    Nontaxable use                                                                    $ .243
b    Use on a farm for farming purposes                                                .243                   } $                            360
c    Use in trains                                                                     .243                                                  353
d    Use in certain intercity and local buses (see Caution  
     above line 1)                                                                     .17                                                   350
e    Exported                                                                          .244                                                  413
4    Nontaxable Use of Undyed Kerosene (Other Than Kerosene Used in Aviation)
     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 an explanation and check here .  . .
                                                                 (a) Type of use    (b) Rate  (c) Gallons        (d) Amount of credit      (e) CRN
a    Nontaxable use taxed at $.244                                                     $ .243
b    Use on a farm for farming purposes                                                .243                   } $                            346
c    Use in certain intercity and local buses (see Caution  
     above line 1)                                                                     .17                                                   347
d    Exported                                                                          .244                                                  414
e    Nontaxable use taxed at $.044                                                     .043                                                  377
f    Nontaxable use taxed at $.219                                                     .218                                                  369
For Paperwork Reduction Act Notice, see the separate instructions.                            Cat. No. 12625R     Form 4136 (2022)

Form 4136 (2022)                                                                                                                          Page 2 
5 Kerosene Used in Aviation  

                                                             (a) Type of use (b) Rate (c) Gallons                 (d) Amount of credit  (e) 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
6 Sales by Registered Ultimate Vendors of Undyed Diesel Fuel                          Registration No. 
  Claimant certifies that it sold the diesel fuel 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 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 an explanation and check here . .
                                                                             (b) Rate (c) Gallons                 (d) Amount of credit  (e) CRN
a Use by a state or local government                                         $ .243                            $                          360
b Use in certain intercity and local buses                                   .17                                                          350
7 Sales by Registered Ultimate Vendors of Undyed Kerosene  
  (Other Than Kerosene for Use in Aviation)                                           Registration No.

  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 did not contain visible evidence of dye.
  Exception. If any of the kerosene included in this claim did contain visible evidence of dye, attach an explanation and check here .  . .
                                                                             (b) Rate (c) Gallons                 (d) Amount of credit  (e) CRN
a Use by a state or local government                                         $ .243
b Sales from a blocked pump                                                  .243                 } $                                     346
c Use in certain intercity and local buses                                   .17                                                          347

8 Sales by Registered Ultimate Vendors of Kerosene for Use in Aviation                Registration No.

  Claimant sold the kerosene for use in aviation at a tax-excluded price and has not collected the amount of tax from the buyer, repaid the 
  amount of tax to the buyer, or has obtained the written consent of the buyer to make the claim. See the instructions for additional information 
  to be submitted.
                                                             (a) Type of use (b) Rate (c) Gallons                 (d) Amount of credit  (e) 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
                                                                                                                  Form 4136 (2022)

Form 4136 (2022)                                                                                                              Page 3 
9  Reserved for future use                                                           Registration No.
                                                                            (b) Rate (c) Gallons        (d) Amount of credit  (e) CRN
                                                                                     of alcohol 
a  Reserved for future use                                                                             $
b  Reserved for future use
10 Biodiesel, Renewable Diesel, or Sustainable Aviation Fuel Mixture                 Registration No.
   Credit
   Biodiesel or renewable diesel mixtures. Claimant produced a mixture by mixing biodiesel with diesel fuel or renewable diesel with liquid fuel 
   (other than renewable diesel). The biodiesel used to produce the biodiesel mixture met ASTM D6751 and met EPA’s registration requirements 
   for  fuels  and  fuel  additives.  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. 
   Sustainable aviation fuel (SAF) mixtures. Claimant produced a qualified mixture by mixing SAF with kerosene. The qualified mixture was 
   produced by the claimant in the United States, such mixture was used by the claimant (or sold by the claimant for use) in an aircraft, such sale 
   or use was in the ordinary course of a trade or business of the claimant, and the transfer of such mixture to the fuel tank of such aircraft 
   occurred in the United States. The SAF used to produce the qualified mixture is the portion of liquid fuel that is not kerosene that (i) either (A) 
   meets the specifications of one of the ASTM D7566 Annexes, or (B) meets the specifications of ASTM D1655 Annex A1, (ii) is not derived from 
   coprocessing an applicable material (or materials derived from an applicable material) with a feedstock that is not biomass, (iii) is not derived 
   from palm fatty acid distillates or petroleum, and (iv) has been certified in accordance with section 40B(e) as having a lifecycle greenhouse gas 
   emissions reduction percentage of at least 50 percent. For all claims. Claimant has attached the appropriate certificates and, if applicable, 
   appropriate  reseller  statements.  Claimant  has  no  reason  to  believe  that  the  information  in  the  certificate  or  statement  is  false.  See  the 
   instructions for additional information and requirements.
                                                                            (b) Rate (c) Number         (d) Amount of credit  (e) CRN
                                                                                     of gallons sold  
                                                                                     or used
a  Biodiesel (other than agri-biodiesel) mixtures                           $1.00                      $                      388
b  Agri-biodiesel mixtures                                                  1.00                                              390
c  Renewable diesel mixtures                                                1.00                                              307
d  Sustainable aviation fuel mixtures (see instructions)                                                                      440
11 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.
                                                            (a) Type of use (b) Rate (c) Gallons,       (d) Amount of credit  (e) CRN
                                                                                      or gasoline  
                                                                                     or diesel gallon  
                                                                                     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
                                                                                                         Form 4136 (2022)

Form 4136 (2022)                                                                                                                     Page 4 
12 Alternative Fuel Credit                                                                Registration No.

   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.
                                                                               (b) Rate       (c) Gallons, or   (d) Amount of credit (e) CRN
                                                                                          gasoline or diesel 
                                                                                          gallon equivalents 
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 (terminated after 12/31/2022)                              .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
13 Registered Credit Card Issuers                                                         Registration No.

                                                                               (b) Rate       (c) Gallons       (d) Amount of credit (e) CRN
a  Diesel fuel sold for the exclusive use of a state or local government         $ .243                       $                      360
b  Kerosene sold for the exclusive use of a state or local government            .243                                                346
c  Kerosene for use in aviation sold for the exclusive use of a state or local 
   government taxed at $.219                                                     .218                                                369
14 Nontaxable Use of a Diesel-Water Fuel Emulsion
   Caution: There is a reduced credit rate for use in certain intercity and local buses (type of use 5). See instructions. 
                                                    (a) Type of use            (b) Rate       (c) Gallons       (d) Amount of credit (e) CRN
a  Nontaxable use                                                                $ .197                       $                      309
b  Exported                                                                      .198                                                306
15 Diesel-Water Fuel Emulsion Blending                                                    Registration No.

                                                                               (b) Rate       (c) Gallons       (d) Amount of credit (e) CRN
   Blender credit                                                                $ .046                       $                      310
16 Exported Dyed Fuels and Exported Gasoline Blendstocks

                                                                               (b) Rate       (c) Gallons       (d) Amount of credit (e) CRN
a  Exported dyed diesel fuel and exported gasoline blendstocks taxed  
   at $.001                                                                      $ .001                       $                      415
b  Exported dyed kerosene                                                        .001                                                416

17 Total income tax credit claimed.   Add lines 1 through 16, column (d). Enter here and on 
   Schedule 3 (Form 1040), line 12; Form 1120, Schedule J, line 20b; Form 1120-S, line 23c; 
   Form 1041, Schedule G, line 16b; or the proper line of other returns  .     . . .    . .   . . 17          $
                                                                                                                Form 4136 (2022)