2023 Form 4136

Form 4136

Department of the Treasury

Internal Revenue Service

Credit for Federal Tax Paid on Fuels

Go to www.irs.gov/Form4136 for instructions and the latest information.

OMB No. 1545-0162

2023

Attachment

Sequence No.

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.

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

Off-highway business use $ .183

Use on a farm for farming purposes .183 362

Other nontaxable use (see Caution above line 1) .183 $

Exported .184 411

}

Nontaxable Use of Aviation Gasoline

(a) Type of use (b) Rate (c) Gallons (d) Amount of credit (e) CRN

Use in commercial aviation (other than foreign trade) $ .15 $ 354

Other nontaxable use (see Caution above line 1)

.193

324

Exported .194 412

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

Nontaxable use $ .243

Use on a farm for farming purposes .243 $ 360

Use in trains .243 353

Use in certain intercity and local buses (see Caution

above line 1)

.17 350

Exported .244 413

}

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

Nontaxable use taxed at $.244 $ .243

Use on a farm for farming purposes

.243 $ 346

Use in certain intercity and local buses (see Caution

above line 1)

.17 347

Exported .244 414

Nontaxable use taxed at $.044 .043 377

Nontaxable use taxed at $.219 .218 369

}

For Paperwork Reduction Act Notice, see the separate instructions.

Cat. No. 12625R

Form 4136 (2023)

Page 2

5 Kerosene Used in Aviation

(a) Type of use (b) Rate (c) Gallons

(d) Amount of credit

(e) CRN

Kerosene used in commercial aviation (other than

foreign trade) taxed at $.244

$ .200 $ 417

Kerosene used in commercial aviation (other than

foreign trade) taxed at $.219

.175 355

Nontaxable use (other than use by state or local

government) taxed at $.244

.243 346

Nontaxable use (other than use by state or local

government) taxed at $.219

.218 369

LUST tax on aviation fuels used in foreign trade .001 433

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

Use by a state or local government $ .243 $ 360

Use in certain intercity and local buses .17 350

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

Use by a state or local government $ .243

Sales from a blocked pump .243 $ 346

Use in certain intercity and local buses .17 347

}

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

Use in commercial aviation (other than foreign trade)

taxed at $.219

$ .175

$ 355

Use in commercial aviation (other than foreign trade)

taxed at $.244

.200 417

Nonexempt use in noncommercial aviation .025 418

Other nontaxable uses taxed at $.244 .243 346

Other nontaxable uses taxed at $.219 .218 369

LUST tax on aviation fuels used in foreign trade .001 433

Form 4136 (2023)

Page 3

9 Reserved for future use

Registration No.

(b) Rate (c) Gallons

of alcohol

(d) Amount of credit (e) CRN

a Reserved for future use

b Reserved for future use

10 Biodiesel, Renewable Diesel, or Sustainable Aviation Fuel Mixture

Credit

Registration No.

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

of gallons sold

or used

(d) Amount of credit (e) CRN

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

or gasoline

or diesel gallon

equivalents

(d) Amount of credit

(e) CRN

Liquefied petroleum gas (LPG) (see instructions) $ .183 $ 419

“P Series” fuels .183 420

Compressed natural gas (CNG) (see instructions) .183 421

Liquefied hydrogen .183 422

Fischer-Tropsch process liquid fuel from coal

(including peat)

.243 423

Liquid fuel derived from biomass .243 424

Liquefied natural gas (LNG) (see instructions) .243 425

Liquefied gas derived from biomass .183 435

Form 4136 (2023)

Page 4

Alternative Fuel Credit

Registration No.

(b) Rate

gasoline or diesel

gallon equivalents

(d) Amount of credit (e) CRN

Liquefied petroleum gas (LPG) (see instructions) $ .50

$ 426

“P Series” fuels .50

427

Compressed natural gas (CNG) (see instructions) .50

428

Reserved for future use

Fischer-Tropsch process liquid fuel from coal (including peat) .50

430

Liquid fuel derived from biomass .50

431

Liquefied natural gas (LNG) (see instructions) .50

432

Liquefied gas derived from biomass .50

436

Compressed gas derived from biomass .50

437

Registered Credit Card Issuers

Registration No.

(b) Rate (c) Gallons (d) Amount of credit (e) CRN

Diesel fuel sold for the exclusive use of a state or local government $ .243 $ 360

Kerosene sold for the exclusive use of a state or local government .243 346

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

Nontaxable use $ .197 $ 309

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

Exported Dyed Fuels and Exported Gasoline Blendstocks

(b) Rate (c) Gallons (d) Amount of credit (e) CRN

Exported dyed diesel fuel and exported gasoline blendstocks taxed

at $.001

$ .001 $ 415

Exported dyed kerosene .001 416

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 24c;

Form 1041, Schedule G, line 17; or the proper line of other returns . . . . . . . .

Form 4136 (2023)