Motor Fuels Forms

There are some forms available in a “fill-in” format, meaning you can view, complete, and print the form from your computer.

  • There is no computation, validation, or verification of the information you enter.
  • You are responsible for entering all required information.
  • Instructions may require some information to be handwritten on the printed form (for example, signatures).
  • You must fill in the form and print it out in one session.
  • You should print 2 copies in order to file one with the Nebraska Department of Revenue and keep the other for your records.

Applications

Form Title

Form #

Document

Nebraska Motor Fuels License Application (11/2024)

20MF

Form

Motor Fuels Application for Abatement of Penalty (8/2020)

21MF

Form

Nebraska Motor Fuels Tax Bond (9/2021)

70

Form

Nebraska Motor Fuels Tax Bond Rider (9/2021)

70XN

Form

Nebraska Non-Ag Use Motor Fuels Tax Refund Claim (11/2020)

84

Form

Refund Rate Table (06/2024)

Form

Nebraska Ag Use Motor Fuels Tax Refund Claim (11/2020)

84AG

Form

Nebraska Extension of Statute of Limitations Agreement for Motor Fuels Programs (08/2020)

872N-MF

Form

Tax Exempt Certificate for Purchase of Undyed Diesel Fuel (08/2020)

91EX

Form

Nebraska Retailer's Claim for Exempt Sales of Motor Fuels (09/2021)

RC73

Form

Tax Returns

Effective January 1, 2002, paper returns were eliminated and EDI (electronic data interchange) became the only filing method available. On January 1, 2005, the Form 73 was modified to include reporting of environmental fees (PRF), aircraft fuel tax liabilities, and compressed fuels thereby eliminating the Forms 82 - Petroleum Release Remedial Action Fee Return and the Form 85 - Nebraska Aircraft Fuels Tax Return. Also on January 1, 2005, a new EDI return was introduced exclusively for ethanol and biodiesel producers, the Form 83 - Nebraska Ethanol and Biodiesel Producer's Return and supporting schedules.

We do maintain the ability for certain returns to be filed "online." This is limited to the Forms 74 and 86. A registration process is required to obtain permission to file these "online" forms. 

The following "sample" returns and schedules are provided to illustrate how the various liabilities are computed. Only EDI returns may be submitted.
 

Form Title

Form #

Document

Nebraska Monthly Fuels Tax Return (07/2024)

73

Form

Nebraska Multiple Schedule of Receipts (07/2024)

73 MFR

Form

Nebraska Multiple Schedule of Disbursements (07/2024)

73 MFD

Form

Nebraska Ethanol & Biodiesel Producer's Return (07/2024)

83

Form

Nebraska Producer's Schedule of Receipts (07/2024)

83 MFR

Form

Nebraska Producer's Schedule of Disbursements (07/2024)

83 MFD

Form

Nebraska Motor Fuels Terminal Operator Report (06/2005)

87

Form

Nebraska Motor Fuels Terminal Operator Schedule of Receipts (04/2007)

87

Form

Nebraska Motor Fuels Terminal Operator Schedule of Disbursements (04/2007)

87

Form

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