TELEPHONE NUMBER 850 617 3711. HSMV 85921 7/11 INSTRUCTIONS FOR COMPLETING TAX RETURN Designate the appropriate fuel type. PAGE 1 NAME AS SHOWN ON HSMV 85921 Tax Return Form A D B C TAXABLE TOTAL MILES TOTAL IN EACH MILES FEI/SSN E TAX PAID GALLONS PLACED IN VEHICLES Col. C / MPG F G TAX RATE / SURCHARGE RATE Col. D Col. E H TAX DUE CREDIT I INTEREST DUE J TOTAL DUE / Col. H I Col. F X Col. G see Tax Rate Chart TOTAL ALL NON IFTA JURISDICTIONS This Page Enter on Page 2 HSMV 85922...
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