This form contains 714 fields organized into 83 sections, giving it a Form Complexity Index of 80/100 (very complex). Below is a complete list of every field, its type, and what information is expected.

Field Name	Type	Description
Additional Information
Floor Stocks Tax (Form 6627) — Rate	Number	Enter the rate applicable to the floor stocks tax for ozone-depleting chemicals (as calculated or reported on Form 6627).
Floor Stocks Tax (Form 6627) — Tax Amount	Number	Enter the tax amount due for the floor stocks tax on ozone-depleting chemicals as calculated on or reported with Form 6627. Max length: 3 characters
Repurchase of Corporate Stock — Tax Amount	Number	Enter the tax amount owed for repurchase of corporate stock as reported and calculated on Form 7208.
	Text	Provide the necessary information for this section.
Chemicals (other than ODCs) (line 54)
Chemicals (other than ODCs) — tax amount (line 54)	Number	Enter the total excise tax amount for chemicals (other than ozone-depleting chemicals) for this quarter in dollars and cents.
IRS line number for chemicals (line 54)	Text	Enter the IRS line number code that corresponds to the Chemicals (other than ODCs) entry (typically '54'). Max length: 3 characters
Claim Amount
topmostSubform[0].Page5[0].Table_Line5[0].Line5d[0].AmountOfClaim[0].f5_129[0	Text	Enter the amount of the claim for Line 5d. This should be the monetary value you are claiming.
topmostSubform[0].Page5[0].Table_Line5[0].Line5d[0].AmountOfClaim[0].f5_130[0	Text	Enter the amount of the claim for Line 5d. This should be a numerical value with a maximum length of 3 digits. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line5[0].Line5e[0].AmountOfClaim[0].f5_135[0	Text	Enter the amount of the claim for Line 5e. This should be the monetary value you are claiming.
topmostSubform[0].Page5[0].Table_Line5[0].Line5e[0].AmountOfClaim[0].f5_136[0	Text	Enter the amount of the claim for Line 5e. This should be a numerical value with a maximum length of 3 digits. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line6[0].Line6d[0].AmountOfClaim[0].f6_20[0	Text	Enter the amount of the claim for Line 6d. This should be the monetary value you are claiming.
topmostSubform[0].Page6[0].Table_Line6[0].Line6d[0].AmountOfClaim[0].f6_21[0	Text	Enter the amount of the claim for Line 6d. This field has a maximum length of 3 characters. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line6[0].Line6e[0].AmountOfClaim[0].f6_26[0	Text	Enter the amount of the claim for Line 6e. This should be the monetary value you are claiming.
topmostSubform[0].Page6[0].Table_Line6[0].Line6e[0].AmountOfClaim[0].f6_27[0	Text	Enter the amount of the claim for Line 6e. This field has a maximum length of 3 characters. Max length: 3 characters
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13c[0].AmountOfClaim[0].f7_36[0	Text	Enter the amount of the claim for Line 13c on Page 7. This field is used to specify the monetary value of the claim related to the excise tax.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13c[0].AmountOfClaim[0].f7_37[0	Text	Enter the amount of the claim for Line 13c on Page 7. This field is used to specify the monetary value of the claim related to the excise tax. The maximum length for this field is 3 characters. Max length: 3 characters
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13d[0].AmountOfClaim[0].f7_41[0	Text	Enter the amount of the claim for Line 13d on Page 7. This field is used to specify the monetary value of the claim related to the excise tax.
Claims
4 4 9f9b Claims (see instructions; complete Schedule C)	Text	Enter the claims amount as per the instructions and complete Schedule C. Max length: 3 characters
Schedule C Claims	Text	Provide details for Schedule C claims.
topmostSubform[0].Page5[0].f5_2[0	Text	Provide additional details for Schedule C claims.
topmostSubform[0].Page5[0].Table_Line1[0].Line1a[0].f5_3[0	Text	Enter the information for Line 1a of the claims table.
topmostSubform[0].Page5[0].Table_Line1[0].Line1a[0].f5_4[0	Text	Enter additional information for Line 1a of the claims table.
topmostSubform[0].Page5[0].Table_Line1[0].Line1a[0].f5_5[0	Text	Enter further details for Line 1a of the claims table.
topmostSubform[0].Page5[0].Table_Line1[0].Line1a[0].AmountOfClaim[0].f5_6[0	Text	Enter the amount of the claim for Line 1a.
topmostSubform[0].Page5[0].Table_Line1[0].Line1a[0].AmountOfClaim[0].f5_7[0	Text	Enter the amount of the claim for Line 1a. Maximum length is 3 characters. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line1[0].Line1a[0].f5_8[0	Text	Enter additional information for Line 1a of the claims table.
topmostSubform[0].Page5[0].Table_Line1[0].LIne1b[0].f5_9[0	Text	Enter the information for Line 1b of the claims table.
Claims and Refunds
topmostSubform[0].Page3[0].c3_3[0]_1	CheckBox	Check this box if a claim for a refund or credit is being made.
topmostSubform[0].Page5[0].Table_Line2[0].Line2a[0].AmountOfClaim[0].f5_20[0	Text	Enter the amount of claim for Line 2a. This field is limited to 3 characters. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line2[0].Line2a[0].f5_21[0	Text	Provide additional details for Line 2a.
topmostSubform[0].Page5[0].Table_Line2[0].Line2b[0].f5_22[0	Text	Provide details for Line 2b.
topmostSubform[0].Page5[0].Table_Line2[0].Line2b[0].f5_23[0	Text	Provide additional details for Line 2b.
topmostSubform[0].Page5[0].Table_Line2[0].Line2b[0].f5_24[0	Text	Provide further details for Line 2b.
topmostSubform[0].Page5[0].Table_Line2[0].Line2b[0].AmountOfClaim[0].f5_25[0	Text	Enter the amount of claim for Line 2b.
topmostSubform[0].Page5[0].Table_Line2[0].Line2b[0].AmountOfClaim[0].f5_26[0	Text	Enter the amount of claim for Line 2b. This field is limited to 3 characters. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line2[0].Line2b[0].f5_27[0	Text	Provide additional details for Line 2b.
topmostSubform[0].Page5[0].Table_Line2[0].Line2c[0].f5_28[0	Text	Provide details for Line 2c.
topmostSubform[0].Page5[0].Table_Line2[0].Line2c[0].f5_29[0	Text	Provide additional details for Line 2c.
topmostSubform[0].Page5[0].Table_Line3[0].Line3d[0].AmountOfClaim[0].f5_62[0	Text	Enter the amount of claim related to Line 3d on Page 5. This field is used to specify the amount being claimed for a refund or credit.
topmostSubform[0].Page5[0].Table_Line3[0].Line3d[0].AmountOfClaim[0].f5_63[0	Text	Enter the amount of claim related to Line 3d on Page 5. This field is used to specify the amount being claimed for a refund or credit. Note that the maximum length for this field is 3 characters. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line3[0].Line3e[0].AmountOfClaim[0].f5_68[0	Text	Enter the amount of claim related to Line 3e on Page 5. This field is used to specify the amount being claimed for a refund or credit.
topmostSubform[0].Page5[0].Table_Line3[0].Line3e[0].AmountOfClaim[0].f5_69[0	Text	Enter the amount of claim for Line 3e. This field is limited to 3 characters. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line3[0].Line3e[0].f5_70[0	Text	Provide the necessary details for Line 3e.
topmostSubform[0].Page5[0].f5_71[0	Text	Provide additional information for Line 3e.
topmostSubform[0].Page5[0].c5_2[0]_1	CheckBox	Check this box if applicable for Line 3e.
topmostSubform[0].Page5[0].Table_Line4[0].Line4a[0].f5_72[0	Text	Enter the details for Line 4a.
topmostSubform[0].Page5[0].Table_Line4[0].Line4a[0].f5_73[0	Text	Provide additional information for Line 4a.
topmostSubform[0].Page5[0].Table_Line4[0].Line4a[0].f5_74[0	Text	Enter further details for Line 4a.
topmostSubform[0].Page5[0].Table_Line4[0].Line4a[0].AmountOfClaim[0].f5_75[0	Text	Enter the amount of claim for Line 4a.
topmostSubform[0].Page5[0].Table_Line4[0].Line4a[0].AmountOfClaim[0].f5_76[0	Text	Enter the amount of claim for Line 4a. This field is limited to 3 characters. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line4[0].Line4a[0].f5_77[0	Text	Provide additional information for Line 4a.
topmostSubform[0].Page5[0].Table_Line4[0].Line4c[0].AmountOfClaim[0].f5_88[0	Text	Enter the amount of claim for Line 4c. This field is limited to 3 characters. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line4[0].Line4c[0].f5_89[0	Text	Provide the necessary details for Line 4c.
topmostSubform[0].Page5[0].Table_Line4[0].Line4d[0].f5_90[0	Text	Provide the necessary details for Line 4d.
topmostSubform[0].Page5[0].Table_Line4[0].Line4d[0].f5_91[0	Text	Provide the necessary details for Line 4d.
topmostSubform[0].Page5[0].Table_Line4[0].Line4d[0].f5_92[0	Text	Provide the necessary details for Line 4d.
topmostSubform[0].Page5[0].Table_Line4[0].Line4d[0].AmountOfClaim[0].f5_93[0	Text	Enter the amount of claim for Line 4d.
topmostSubform[0].Page5[0].Table_Line4[0].Line4d[0].AmountOfClaim[0].f5_94[0	Text	Enter the amount of claim for Line 4d. This field is limited to 3 characters. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line4[0].Line4d[0].f5_95[0	Text	Provide the necessary details for Line 4d.
topmostSubform[0].Page5[0].Table_Line4[0].Line4e[0].f5_96[0	Text	Provide the necessary details for Line 4e.
topmostSubform[0].Page5[0].Table_Line4[0].Line4e[0].f5_97[0	Text	Provide the necessary details for Line 4e.
topmostSubform[0].Page5[0].Table_Line5[0].Line5b[0].AmountOfClaim[0].f5_117[0	Text	Enter the amount of claim for Line 5b. This field is used to report specific claims related to excise taxes.
topmostSubform[0].Page5[0].Table_Line5[0].Line5b[0].AmountOfClaim[0].f5_118[0	Text	Enter the amount of claim for Line 5b. This field is used to report specific claims related to excise taxes. The maximum length is 3 characters. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line5[0].Line5b[0].f5_119[0	Text	Enter the relevant information for Line 5b. This field is used to provide additional details related to excise tax claims.
topmostSubform[0].Page5[0].Table_Line5[0].Line5c[0].f5_120[0	Text	Enter the relevant information for Line 5c. This field is used to provide additional details related to excise tax claims.
topmostSubform[0].Page5[0].Table_Line5[0].Line5c[0].f5_121[0	Text	Enter the relevant information for Line 5c. This field is used to provide additional details related to excise tax claims.
topmostSubform[0].Page5[0].Table_Line5[0].Line5c[0].f5_122[0	Text	Enter the relevant information for Line 5c. This field is used to provide additional details related to excise tax claims.
topmostSubform[0].Page5[0].Table_Line5[0].Line5c[0].AmountOfClaim[0].f5_123[0	Text	Enter the amount of claim for Line 5c. This field is used to report specific claims related to excise taxes.
topmostSubform[0].Page5[0].Table_Line5[0].Line5c[0].AmountOfClaim[0].f5_124[0	Text	Enter the amount of claim for Line 5c. This field is used to report specific claims related to excise taxes. The maximum length is 3 characters. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line5[0].Line5c[0].f5_125[0	Text	Enter the relevant information for Line 5c. This field is used to provide additional details related to excise tax claims.
topmostSubform[0].Page5[0].Table_Line5[0].Line5d[0].f5_126[0	Text	Enter the relevant information for Line 5d. This field is used to provide additional details related to excise tax claims.
topmostSubform[0].Page6[0].Table_Line6[0].Line6a[0].AmountOfClaim[0].f6_3[0	Text	Enter the amount of claim for Line 6a on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line6[0].Line6a[0].AmountOfClaim[0].f6_4[0	Text	Enter the amount of claim for Line 6a on Page 6 of Form 720. Maximum length is 3 characters. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line6[0].Line6b[0].AmountOfClaim[0].f6_8[0	Text	Enter the amount of claim for Line 6b. This field is used to report the specific amount you are claiming for a refund or credit.
topmostSubform[0].Page6[0].Table_Line6[0].Line6b[0].AmountOfClaim[0].f6_9[0	Text	Enter the amount of claim for Line 6b. This field is used to report the specific amount you are claiming for a refund or credit. The value should be a maximum of 3 characters. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line6[0].Line6b[0].f6_10[0	Text	Provide additional details or breakdown for the amount of claim in Line 6b.
topmostSubform[0].Page6[0].Table_Line6[0].Line6c[0].f6_11[0	Text	Enter the amount of claim for Line 6c. This field is used to report the specific amount you are claiming for a refund or credit.
topmostSubform[0].Page6[0].Table_Line6[0].Line6c[0].f6_12[0	Text	Provide additional details or breakdown for the amount of claim in Line 6c.
topmostSubform[0].Page6[0].Table_Line6[0].Line6c[0].f6_13[0	Text	Provide additional details or breakdown for the amount of claim in Line 6c.
topmostSubform[0].Page6[0].Table_Line6[0].Line6c[0].AmountOfClaim[0].f6_14[0	Text	Enter the amount of claim for Line 6c. This field is used to report the specific amount you are claiming for a refund or credit.
topmostSubform[0].Page6[0].Table_Line6[0].Line6c[0].AmountOfClaim[0].f6_15[0	Text	Enter the amount of claim for Line 6c. This field is used to report the specific amount you are claiming for a refund or credit. The value should be a maximum of 3 characters. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line6[0].Line6c[0].f6_16[0	Text	Provide additional details or breakdown for the amount of claim in Line 6c.
topmostSubform[0].Page6[0].Table_Line6[0].Line6d[0].f6_17[0	Text	Provide additional details or breakdown for the amount of claim in Line 6d.
topmostSubform[0].Page6[0].Table_Line6[0].Line6g[0].AmountOfClaim[0].f6_38[0	Text	Enter the amount of claim for Line 6g. This field is used to report the specific amount you are claiming for this line item.
topmostSubform[0].Page6[0].Table_Line6[0].Line6g[0].AmountOfClaim[0].f6_39[0	Text	Enter a short code or identifier for the amount of claim for Line 6g. This field has a maximum length of 3 characters. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line6[0].Line6g[0].f6_40[0	Text	Provide additional details or notes related to the amount of claim for Line 6g.
topmostSubform[0].Page6[0].Table_Line6[0].Line6h[0].f6_41[0	Text	Enter the amount of claim for Line 6h. This field is used to report the specific amount you are claiming for this line item.
topmostSubform[0].Page6[0].Table_Line6[0].Line6h[0].f6_42[0	Text	Provide additional details or notes related to the amount of claim for Line 6h.
topmostSubform[0].Page6[0].Table_Line6[0].Line6h[0].f6_43[0	Text	Enter any other relevant information or notes for Line 6h.
topmostSubform[0].Page6[0].Table_Line6[0].Line6h[0].AmountOfClaim[0].f6_44[0	Text	Enter the amount of claim for Line 6h. This field is used to report the specific amount you are claiming for this line item.
topmostSubform[0].Page6[0].Table_Line6[0].Line6h[0].AmountOfClaim[0].f6_45[0	Text	Enter a short code or identifier for the amount of claim for Line 6h. This field has a maximum length of 3 characters. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line6[0].Line6h[0].f6_46[0	Text	Provide additional details or notes related to the amount of claim for Line 6h.
topmostSubform[0].Page6[0].Table_Line7[0].Line7b[0].AmountOfClaim[0].f6_57[0	Text	Enter the amount of claim for Line 7b. This field is limited to 3 characters. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line7[0].Line7b[0].f6_58[0	Text	Provide the necessary details for Line 7b.
topmostSubform[0].Page6[0].f6_59[0	Text	Provide additional information for Line 7b.
topmostSubform[0].Page6[0].Table_Line8[0].Line8a[0].f6_61[0	Text	Provide the necessary details for Line 8a.
topmostSubform[0].Page6[0].Table_Line8[0].Line8a[0].f6_62[0	Text	Provide additional information for Line 8a.
topmostSubform[0].Page6[0].Table_Line8[0].Line8a[0].AmountOfClaim[0].f6_63[0	Text	Enter the amount of claim for Line 8a.
topmostSubform[0].Page6[0].Table_Line8[0].Line8a[0].AmountOfClaim[0].f6_64[0	Text	Enter the amount of claim for Line 8a. This field is limited to 3 characters. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line8[0].Line8a[0].f6_65[0	Text	Provide additional information for Line 8a.
topmostSubform[0].Page6[0].Table_Line8[0].Line8b[0].f6_66[0	Text	Provide the necessary details for Line 8b.
topmostSubform[0].Page6[0].Table_Line9[0].Line9a[0].AmountOfClaim[0].f6_80[0	Text	Enter the amount of claim for Line 9a on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line9[0].Line9a[0].AmountOfClaim[0].f6_81[0	Text	Enter the amount of claim for Line 9a on Page 6 of Form 720. Maximum length is 3 characters. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line9[0].Line8b[0].AmountOfClaim[0].f6_86[0	Text	Enter the amount of claim for Line 8b on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line9[0].Line8b[0].AmountOfClaim[0].f6_87[0	Text	Enter the amount of claim for Line 8b. This field is limited to 3 characters. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line9[0].Line8b[0].f6_88[0	Text	Provide the necessary details for Line 8b.
topmostSubform[0].Page6[0].Table_Line9[0].Line8c[0].f6_89[0	Text	Provide the necessary details for Line 8c.
topmostSubform[0].Page6[0].Table_Line9[0].Line8c[0].f6_90[0	Text	Provide the necessary details for Line 8c.
topmostSubform[0].Page6[0].Table_Line9[0].Line8c[0].f6_91[0	Text	Provide the necessary details for Line 8c.
topmostSubform[0].Page6[0].Table_Line9[0].Line8c[0].AmountOfClaim[0].f6_92[0	Text	Enter the amount of claim for Line 8c.
topmostSubform[0].Page6[0].Table_Line9[0].Line8c[0].AmountOfClaim[0].f6_93[0	Text	Enter the amount of claim for Line 8c. This field is limited to 3 characters. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line9[0].Line8c[0].f6_94[0	Text	Provide the necessary details for Line 8c.
topmostSubform[0].Page6[0].Table_Line9[0].Line8d[0].f6_95[0	Text	Provide the necessary details for Line 8d.
topmostSubform[0].Page6[0].Table_Line9[0].Line8d[0].f6_96[0	Text	Provide the necessary details for Line 8d.
topmostSubform[0].Page6[0].Table_Line10[0].Line10a[0].AmountOfClaim[0].f6_117[0	Text	Enter the amount of claim for Line 10a. This field is limited to 3 characters. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line10[0].Line10a[0].f6_118[0	Text	Provide additional details or information related to Line 10a.
topmostSubform[0].Page6[0].Table_Line10[0].Line10b[0].f6_119[0	Text	Provide details for Line 10b.
topmostSubform[0].Page6[0].Table_Line10[0].Line10b[0].f6_120[0	Text	Provide additional information related to Line 10b.
topmostSubform[0].Page6[0].Table_Line10[0].Line10b[0].AmountOfClaim[0].f6_121[0	Text	Enter the amount of claim for Line 10b.
topmostSubform[0].Page6[0].Table_Line10[0].Line10b[0].AmountOfClaim[0].f6_122[0	Text	Enter the amount of claim for Line 10b. This field is limited to 3 characters. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line10[0].Line10b[0].f6_123[0	Text	Provide additional details or information related to Line 10b.
topmostSubform[0].Page6[0].Line11Table[0].Line11a[0].f6_125[0	Text	Provide details for Line 11a.
topmostSubform[0].Page6[0].Line11Table[0].Line11a[0].f6_126[0	Text	Provide additional information related to Line 11a.
topmostSubform[0].Page6[0].Line11Table[0].Line11a[0].AmountOfClaim[0].f6_127[0	Text	Enter the amount of claim for Line 11a on Page 6.
topmostSubform[0].Page6[0].Line11Table[0].Line11a[0].AmountOfClaim[0].f6_128[0	Text	Enter the amount of claim for Line 11a on Page 6. This field has a maximum length of 3 characters. Max length: 3 characters
topmostSubform[0].Page6[0].Line11Table[0].Line11a[0].f6_129[0	Text	Provide additional details for Line 11a on Page 6.
topmostSubform[0].Page6[0].Line11Table[0].Line11b[0].f6_130[0	Text	Provide additional details for Line 11b on Page 6.
topmostSubform[0].Page6[0].Line11Table[0].Line11b[0].f6_131[0	Text	Provide additional details for Line 11b on Page 6.
topmostSubform[0].Page6[0].Line11Table[0].Line11b[0].AmountOfClaim[0].f6_132[0	Text	Enter the amount of claim for Line 11b on Page 6.
topmostSubform[0].Page6[0].Line11Table[0].Line11b[0].AmountOfClaim[0].f6_133[0	Text	Enter the amount of claim for Line 11b on Page 6. This field has a maximum length of 3 characters. Max length: 3 characters
topmostSubform[0].Page6[0].Line11Table[0].Line11b[0].f6_134[0	Text	Provide additional details for Line 11b on Page 6.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13d[0].AmountOfClaim[0].f7_42[0	Text	Enter the amount of claim for Line 13d. This field is limited to 3 characters. Max length: 3 characters
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13d[0].f7_43[0	Text	Provide additional details for Line 13d.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13e[0].f7_44[0	Text	Provide details for Line 13e.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13e[0].f7_45[0	Text	Provide additional details for Line 13e.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13e[0].AmountOfClaim[0].f7_46[0	Text	Enter the amount of claim for Line 13e.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13e[0].AmountOfClaim[0].f7_47[0	Text	Enter the amount of claim for Line 13e. This field is limited to 3 characters. Max length: 3 characters
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13e[0].f7_48[0	Text	Provide additional details for Line 13e.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13f[0].f7_49[0	Text	Provide details for Line 13f.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13f[0].f7_50[0	Text	Provide additional details for Line 13f.
topmostSubform[0].Page7[0].Line14Table[0].Line14d[0].AmountOfClaim[0].f7_78[0	Text	Enter the amount of claim for Line 14d on Page 7.
topmostSubform[0].Page7[0].Line14Table[0].Line14d[0].AmountOfClaim[0].f7_79[0	Text	Enter the amount of claim for Line 14d on Page 7. This field has a maximum length of 3 characters. Max length: 3 characters
topmostSubform[0].Page7[0].Line14Table[0].Line14d[0].f7_80[0	Text	Enter the additional details for Line 14d on Page 7.
topmostSubform[0].Page7[0].Line14Table[0].Ln14e[0].AmountOfClaim[0].f7_81[0	Text	Enter the amount of claim for Line 14e on Page 7.
topmostSubform[0].Page7[0].Line14Table[0].Ln14e[0].AmountOfClaim[0].f7_82[0	Text	Enter the amount of claim for Line 14e on Page 7. This field has a maximum length of 3 characters. Max length: 3 characters
topmostSubform[0].Page7[0].Line14Table[0].Ln14e[0].f7_83[0	Text	Enter the additional details for Line 14e on Page 7.
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14f[0].f7_84[0	Text	Enter the details for Line 14f on Page 7.
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14f[0].AmountOfClaim[0].f7_85[0	Text	Enter the amount of claim for Line 14f on Page 7.
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14f[0].AmountOfClaim[0].f7_86[0	Text	Enter the amount of claim for Line 14f on Page 7. This field has a maximum length of 3 characters. Max length: 3 characters
topmostSubform[0].Page7[0].Line14k[0].AmountOfClaim[0].f7_106[0	Text	Enter the amount of claim for Line 14k. This field is limited to 3 characters. Max length: 3 characters
topmostSubform[0].Page7[0].Line14k[0].f7_107[0	Text	Provide the necessary information for Line 14k.
topmostSubform[0].Page7[0].f7_108[0	Text	Provide the necessary information for this section.
topmostSubform[0].Page7[0].f7_109[0	Text	Enter the required information for this section. This field is limited to 3 characters. Max length: 3 characters
Claims for Refunds or Credits
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13f[0].AmountOfClaim[0].f7_51[0	Text	Enter the amount of claim for Line 13f. This field is used to report specific claims related to excise taxes.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13f[0].AmountOfClaim[0].f7_52[0	Text	Enter a short code or identifier for the claim amount for Line 13f. This field has a maximum length of 3 characters. Max length: 3 characters
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13f[0].f7_53[0	Text	Provide additional details or notes for the claim amount for Line 13f.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13g[0].f7_54[0	Text	Enter the amount of claim for Line 13g. This field is used to report specific claims related to excise taxes.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13g[0].f7_55[0	Text	Provide additional details or notes for the claim amount for Line 13g.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13g[0].AmountOfClaim[0].f7_56[0	Text	Enter the amount of claim for Line 13g. This field is used to report specific claims related to excise taxes.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13g[0].AmountOfClaim[0].f7_57[0	Text	Enter a short code or identifier for the claim amount for Line 13g. This field has a maximum length of 3 characters. Max length: 3 characters
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13g[0].f7_58[0	Text	Provide additional details or notes for the claim amount for Line 13g.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13h[0].f7_59[0	Text	Enter the amount of claim for Line 13h. This field is used to report specific claims related to excise taxes.
topmostSubform[0].Page7[0].Line14Table[0].Line14a[0].AmountOfClaim[0].f7_69[0	Text	Enter the amount of claim for Line 14a. This field is used to report specific claims related to excise taxes.
topmostSubform[0].Page7[0].Line14Table[0].Line14a[0].AmountOfClaim[0].f7_70[0	Text	Enter the amount of claim for Line 14a. This field is used to report specific claims related to excise taxes. The value should be a maximum of 3 characters. Max length: 3 characters
topmostSubform[0].Page7[0].Line14Table[0].Line14a[0].f7_71[0	Text	Provide additional details or descriptions for the claim on Line 14a.
topmostSubform[0].Page7[0].Line14Table[0].Line14b[0].AmountOfClaim[0].f7_72[0	Text	Enter the amount of claim for Line 14b. This field is used to report specific claims related to excise taxes.
topmostSubform[0].Page7[0].Line14Table[0].Line14b[0].AmountOfClaim[0].f7_73[0	Text	Enter the amount of claim for Line 14b. This field is used to report specific claims related to excise taxes. The value should be a maximum of 3 characters. Max length: 3 characters
topmostSubform[0].Page7[0].Line14Table[0].Line14b[0].f7_74[0	Text	Provide additional details or descriptions for the claim on Line 14b.
topmostSubform[0].Page7[0].Line14Table[0].Line14c[0].AmountOfClaim[0].f7_75[0	Text	Enter the amount of claim for Line 14c. This field is used to report specific claims related to excise taxes.
topmostSubform[0].Page7[0].Line14Table[0].Line14c[0].AmountOfClaim[0].f7_76[0	Text	Enter the amount of claim for Line 14c. This field is used to report specific claims related to excise taxes. The value should be a maximum of 3 characters. Max length: 3 characters
topmostSubform[0].Page7[0].Line14Table[0].Line14c[0].f7_77[0	Text	Provide additional details or descriptions for the claim on Line 14c.
Communications and Air Transportation - Local telephone service (line 22)
Line 22 — Local telephone service tax	Number	Enter the tax amount for local telephone service and teletypewriter exchange service to report on line 22 for this quarter.
Line 22 — Supplementary tax amount	Number	Enter any additional tax value associated with line 22 that the form requires to complete the reported tax for this line. Max length: 3 characters
Communications and Air Transportation - Transportation of persons by air (line 26)
Line 26 tax amount (Transportation of persons by air)	Number	Enter the tax amount owed for transportation of persons by air (line 26); include any dollars and cents as a numeric value.
Line number / IRS number for transportation of persons by air	Text	Enter the IRS line or reference number associated with transportation of persons by air (preprinted as 26 on the form). Max length: 3 characters
Communications and Air Transportation - Transportation of property by air (line 28)
Tax — Transportation of property by air (line 28)	Number	Enter the total tax amount owed for transportation of property by air for this quarter.
IRS line number for transportation of property by air	Text	Enter the IRS line number or tax code associated with transportation of property by air (typically '28'). Max length: 3 characters
Communications and Air Transportation - Use of international air travel facilities (line 27)
Line 27 tax — dollars	Number	Enter the dollar portion of the excise tax owed for line 27 (Use of international air travel facilities).
Line 27 tax — cents	Number	Enter the cents portion of the excise tax owed for line 27 (Use of international air travel facilities). Max length: 3 characters
Designee Information
Designee's name	Text	Enter the name of the designee. This is the person authorized to discuss the return with the IRS.
	Text	Enter the title of the designee. This field is for specifying the role or title of the person authorized to discuss the return with the IRS.
topmostSubform[0].Page3[0].PinCombField[0].f3_21[0	Text	Enter the 5-digit PIN of the designee. This is a personal identification number used for security purposes. Max length: 5 characters
Telephone number	Text	Enter the telephone number of the designee. This is the contact number for the person authorized to discuss the return with the IRS.
Domestic petroleum oil spill tax (line 18)
Domestic petroleum oil spill tax — Tax amount (Line 18)	Number	Enter the total tax amount for the domestic petroleum oil spill tax for this quarter (line 18).
Domestic petroleum oil spill tax — IRS line/code	Text	Enter the IRS line or code number associated with this entry (the numeric identifier for the domestic petroleum oil spill tax, line 18). Max length: 3 characters
Domestic petroleum superfund tax (line 53)
Domestic petroleum superfund tax — amount	Number	Enter the domestic petroleum superfund tax amount for line 53 (the main dollar value) that applies to this return.
Domestic petroleum superfund tax — cents	Number	Enter the cents portion of the domestic petroleum superfund tax for line 53. Max length: 3 characters
Excise Tax Calculations
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14f[0].f7_87[0	Text	Enter the specific amount for Line 14f. This field is part of the detailed excise tax calculations.
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14g[0].f7_88[0	Text	Enter the specific amount for Line 14g. This field is part of the detailed excise tax calculations.
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14g[0].AmtG[0].f7_89[0	Text	Enter the amount for Line 14g, column G. This field is part of the detailed excise tax calculations.
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14g[0].AmtG[0].f7_90[0	Text	Enter the amount for Line 14g, column G. This field is part of the detailed excise tax calculations. The maximum length for this field is 3 characters. Max length: 3 characters
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14g[0].f7_91[0	Text	Enter the specific amount for Line 14g. This field is part of the detailed excise tax calculations.
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14h[0].f7_92[0	Text	Enter the specific amount for Line 14h. This field is part of the detailed excise tax calculations.
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14h[0].AmtH[0].f7_93[0	Text	Enter the amount for Line 14h, column H. This field is part of the detailed excise tax calculations.
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14h[0].AmtH[0].f7_94[0	Text	Enter the amount for Line 14h, column H. This field is part of the detailed excise tax calculations. The maximum length for this field is 3 characters. Max length: 3 characters
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14h[0].f7_95[0	Text	Enter the specific amount for Line 14h. This field is part of the detailed excise tax calculations.
Excise Tax Claim Amount
topmostSubform[0].Page5[0].Table_Line3[0].Line3b[0].AmountOfClaim[0].f5_50[0	Text	Enter the amount of the claim for Line 3b on Page 5.
topmostSubform[0].Page5[0].Table_Line3[0].Line3b[0].AmountOfClaim[0].f5_51[0	Text	Enter the amount of the claim for Line 3b on Page 5. The value should be a maximum of 3 characters. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line3[0].Line3c[0].AmountOfClaim[0].f5_56[0	Text	Enter the amount of the claim for Line 3c on Page 5.
topmostSubform[0].Page5[0].Table_Line3[0].Line3c[0].AmountOfClaim[0].f5_57[0	Text	Enter the amount of the claim for Line 3c on Page 5. The value should be a maximum of 3 characters. Max length: 3 characters
Excise Tax Claim Details
topmostSubform[0].Page5[0].Table_Line3[0].Line3b[0].f5_49[0	Text	Enter the specific details related to Line 3b of the excise tax claim on Page 5.
topmostSubform[0].Page5[0].Table_Line3[0].Line3b[0].f5_52[0	Text	Enter additional details related to Line 3b of the excise tax claim on Page 5.
topmostSubform[0].Page5[0].Table_Line3[0].Line3c[0].f5_53[0	Text	Enter the specific details related to Line 3c of the excise tax claim on Page 5.
topmostSubform[0].Page5[0].Table_Line3[0].Line3c[0].f5_54[0	Text	Enter additional details related to Line 3c of the excise tax claim on Page 5.
topmostSubform[0].Page5[0].Table_Line3[0].Line3c[0].f5_55[0	Text	Enter further details related to Line 3c of the excise tax claim on Page 5.
topmostSubform[0].Page5[0].Table_Line3[0].Line3c[0].f5_58[0	Text	Enter additional details related to Line 3c of the excise tax claim on Page 5.
Excise Tax Details
topmostSubform[0].Page5[0].Table_Line2[0].Line2c[0].f5_30[0	Text	Enter the specific details related to Line 2c of the excise tax table on Page 5.
topmostSubform[0].Page5[0].Table_Line2[0].Line2c[0].AmountOfClaim[0].f5_31[0	Text	Enter the amount of claim for Line 2c of the excise tax table on Page 5.
topmostSubform[0].Page5[0].Table_Line2[0].Line2c[0].AmountOfClaim[0].f5_32[0	Text	Enter the amount of claim for Line 2c of the excise tax table on Page 5. The value should be a 3-digit number. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line2[0].Line2c[0].f5_33[0	Text	Enter additional details related to Line 2c of the excise tax table on Page 5.
topmostSubform[0].Page5[0].Table_Line2[0].Line2d[0].f5_34[0	Text	Enter the specific details related to Line 2d of the excise tax table on Page 5.
topmostSubform[0].Page5[0].Table_Line2[0].Line2d[0].f5_35[0	Text	Enter additional details related to Line 2d of the excise tax table on Page 5.
topmostSubform[0].Page5[0].Table_Line2[0].Line2d[0].f5_36[0	Text	Enter further details related to Line 2d of the excise tax table on Page 5.
topmostSubform[0].Page5[0].Table_Line2[0].Line2d[0].AmountOfClaim[0].f5_37[0	Text	Enter the amount of claim for Line 2d of the excise tax table on Page 5.
topmostSubform[0].Page5[0].Table_Line2[0].Line2d[0].AmountOfClaim[0].f5_38[0	Text	Enter the amount of claim for Line 2d of the excise tax table on Page 5. The value should be a 3-digit number. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line2[0].Line2d[0].f5_39[0	Text	Enter additional details related to Line 2d of the excise tax table on Page 5.
topmostSubform[0].Page5[0].Table_Line3[0].Line3d[0].f5_59[0	Text	Enter the specific details related to Line 3d, field 59 on Page 5. This field is likely part of the detailed information required for a specific type of excise tax.
topmostSubform[0].Page5[0].Table_Line3[0].Line3d[0].f5_60[0	Text	Enter the specific details related to Line 3d, field 60 on Page 5. This field is likely part of the detailed information required for a specific type of excise tax.
topmostSubform[0].Page5[0].Table_Line3[0].Line3d[0].f5_61[0	Text	Enter the specific details related to Line 3d, field 61 on Page 5. This field is likely part of the detailed information required for a specific type of excise tax.
topmostSubform[0].Page5[0].Table_Line3[0].Line3d[0].f5_64[0	Text	Enter the specific details related to Line 3d, field 64 on Page 5. This field is likely part of the detailed information required for a specific type of excise tax.
topmostSubform[0].Page5[0].Table_Line3[0].Line3e[0].f5_65[0	Text	Enter the specific details related to Line 3e, field 65 on Page 5. This field is likely part of the detailed information required for a specific type of excise tax.
topmostSubform[0].Page5[0].Table_Line3[0].Line3e[0].f5_66[0	Text	Enter the specific details related to Line 3e, field 66 on Page 5. This field is likely part of the detailed information required for a specific type of excise tax.
topmostSubform[0].Page5[0].Table_Line3[0].Line3e[0].f5_67[0	Text	Enter the specific details related to Line 3e, field 67 on Page 5. This field is likely part of the detailed information required for a specific type of excise tax.
topmostSubform[0].Page6[0].Table_Line6[0].Line6d[0].f6_18[0	Text	Enter the specific details related to Line 6d for the excise tax being reported.
topmostSubform[0].Page6[0].Table_Line6[0].Line6d[0].f6_19[0	Text	Provide additional information required for Line 6d of the excise tax section.
topmostSubform[0].Page6[0].Table_Line6[0].Line6d[0].f6_22[0	Text	Provide any other relevant details for Line 6d of the excise tax section.
topmostSubform[0].Page6[0].Table_Line6[0].Line6e[0].f6_23[0	Text	Enter the specific details related to Line 6e for the excise tax being reported.
topmostSubform[0].Page6[0].Table_Line6[0].Line6e[0].f6_24[0	Text	Provide additional information required for Line 6e of the excise tax section.
topmostSubform[0].Page6[0].Table_Line6[0].Line6e[0].f6_25[0	Text	Provide any other relevant details for Line 6e of the excise tax section.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13a[0].f7_24[0	Text	Provide the specific information required for Line 13a, which pertains to a particular type of excise tax or claim.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13a[0].f7_25[0	Text	Provide additional specific information required for Line 13a, which pertains to a particular type of excise tax or claim.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13a[0].AmountOfClaim[0].f7_26[0	Text	Enter the amount of the claim for Line 13a. This should be the monetary value of the claim being made.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13a[0].AmountOfClaim[0].f7_27[0	Text	Enter the amount of the claim for Line 13a. This should be a numerical value with a maximum length of 3 digits. Max length: 3 characters
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13a[0].f7_28[0	Text	Provide additional specific information required for Line 13a, which pertains to a particular type of excise tax or claim.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13b[0].f7_29[0	Text	Provide the specific information required for Line 13b, which pertains to a particular type of excise tax or claim.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13b[0].f7_30[0	Text	Provide additional specific information required for Line 13b, which pertains to a particular type of excise tax or claim.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13b[0].AmountOfClaim[0].f7_31[0	Text	Enter the amount of the claim for Line 13b. This should be the monetary value of the claim being made.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13b[0].AmountOfClaim[0].f7_32[0	Text	Enter the amount of the claim for Line 13b. This should be a numerical value with a maximum length of 3 digits. Max length: 3 characters
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13h[0].f7_60[0	Text	Enter the specific details related to Line 13h for the excise tax being reported.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13h[0].AmountOfClaim[0].f7_61[0	Text	Enter the amount of claim for Line 13h. This is the monetary value you are claiming for this specific excise tax.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13h[0].AmountOfClaim[0].f7_62[0	Text	Enter the amount of claim for Line 13h. This field has a maximum length of 3 characters. Max length: 3 characters
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13h[0].f7_63[0	Text	Enter additional details related to Line 13h for the excise tax being reported.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13i[0].f7_64[0	Text	Enter the specific details related to Line 13i for the excise tax being reported.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13i[0].f7_65[0	Text	Enter additional details related to Line 13i for the excise tax being reported.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13i[0].AmountOfClaim[0].f7_66[0	Text	Enter the amount of claim for Line 13i. This is the monetary value you are claiming for this specific excise tax.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13i[0].AmountOfClaim[0].f7_67[0	Text	Enter the amount of claim for Line 13i. This field has a maximum length of 3 characters. Max length: 3 characters
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13i[0].f7_68[0	Text	Enter additional details related to Line 13i for the excise tax being reported.
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14i[0].f7_96[0	Text	Enter the specific information required for Line 14i, which may pertain to a particular type of excise tax or claim.
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14i[0].AmtI[0].f7_97[0	Text	Enter the amount associated with Line 14i. This should be the monetary value relevant to the specific excise tax or claim.
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14i[0].AmtI[0].f7_98[0	Text	Enter the amount associated with Line 14i. This field has a maximum length of 3 characters, so ensure the value is concise. Max length: 3 characters
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14i[0].f7_99[0	Text	Enter the specific information required for Line 14i, which may pertain to a particular type of excise tax or claim.
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14j[0].f7_100[0	Text	Enter the specific information required for Line 14j, which may pertain to a particular type of excise tax or claim.
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14j[0].AmtJ[0].f7_101[0	Text	Enter the amount associated with Line 14j. This should be the monetary value relevant to the specific excise tax or claim.
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14j[0].AmtJ[0].f7_102[0	Text	Enter the amount associated with Line 14j. This field has a maximum length of 3 characters, so ensure the value is concise. Max length: 3 characters
topmostSubform[0].Page7[0].Table_Line14f-h[0].Line14j[0].f7_103[0	Text	Enter the specific information required for Line 14j, which may pertain to a particular type of excise tax or claim.
topmostSubform[0].Page7[0].Line14k[0].f7_104[0	Text	Enter the specific information required for Line 14k, which may pertain to a particular type of excise tax or claim.
topmostSubform[0].Page7[0].Line14k[0].AmountOfClaim[0].f7_105[0	Text	Enter the amount associated with Line 14k. This should be the monetary value relevant to the specific excise tax or claim.
Excise Taxes Details
topmostSubform[0].Page6[0].Table_Line9[0].Line8f[0].f6_107[0	Text	Enter the specific details related to Line 8f, field 6_107 on Page 6. This field is part of the table for reporting excise taxes.
topmostSubform[0].Page6[0].Table_Line9[0].Line8f[0].f6_108[0	Text	Enter the specific details related to Line 8f, field 6_108 on Page 6. This field is part of the table for reporting excise taxes.
topmostSubform[0].Page6[0].Table_Line9[0].Line8f[0].f6_109[0	Text	Enter the specific details related to Line 8f, field 6_109 on Page 6. This field is part of the table for reporting excise taxes.
topmostSubform[0].Page6[0].Table_Line9[0].Line8f[0].AmountOfClaim[0].f6_110[0	Text	Enter the amount of claim related to Line 8f, field 6_110 on Page 6. This field is part of the table for reporting excise taxes.
topmostSubform[0].Page6[0].Table_Line9[0].Line8f[0].AmountOfClaim[0].f6_111[0	Text	Enter the amount of claim related to Line 8f, field 6_111 on Page 6. This field is part of the table for reporting excise taxes. Note: Maximum length is 3 characters. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line9[0].Line8f[0].f6_112[0	Text	Enter the specific details related to Line 8f, field 6_112 on Page 6. This field is part of the table for reporting excise taxes.
topmostSubform[0].Page6[0].f6_113[0	Text	Enter the specific details related to field 6_113 on Page 6. This field is part of the table for reporting excise taxes.
topmostSubform[0].Page6[0].Table_Line10[0].Line10a[0].f6_114[0	Text	Enter the specific details related to Line 10a, field 6_114 on Page 6. This field is part of the table for reporting excise taxes.
topmostSubform[0].Page6[0].Table_Line10[0].Line10a[0].f6_115[0	Text	Enter the specific details related to Line 10a, field 6_115 on Page 6. This field is part of the table for reporting excise taxes.
topmostSubform[0].Page6[0].Table_Line10[0].Line10a[0].AmountOfClaim[0].f6_116[0	Text	Enter the amount of claim related to Line 10a, field 6_116 on Page 6. This field is part of the table for reporting excise taxes.
Filer information (header)
Final return	Checkbox	Check this box if this is the filer’s final return for the business (the business has closed or will no longer file this tax).
Address change	Checkbox	Check this box if the filer’s mailing address has changed since the last return was filed and the form contains the new address information.
Filer name	Text	Enter the filer’s legal name or business name as it should appear on tax records.
Quarter ending	Date	Enter the date that ends the quarter this return covers.
Street address (number, street, apt/suite)	Text	Enter the filer’s street address including number, street, and room or suite number; if using a P.O. box, follow the form instructions. Fill only if 'Address change' is 'Yes'. Depends on: Address change
City, state/province, country, and ZIP/postal code	Text	Enter the city or town, state or province, country, and ZIP or foreign postal code for the filer’s mailing address. Fill only if 'Address change' is 'Yes'. Depends on: Address change
Employer identification number (EIN)	Text	Enter the filer’s Employer Identification Number (EIN) assigned by the IRS. Max length: 10 characters
Financial Information
Dollars	Text	Enter the amount in dollars.
Cents	Text	Enter the amount in cents. This field is limited to 3 characters. Max length: 3 characters
Foreign Insurance Taxes
Premiums paid — Casualty insurance and indemnity bonds	Number	Enter the total premiums paid to foreign insurers for casualty insurance and indemnity bonds used to calculate the foreign insurance tax.
topmostSubform[0].Page2[0].Table_ForeignInsuranceTaxes[0].IRSno30-1[0].Rate30_1[0].f2_13[0	Text	Enter the rate for the first Foreign Insurance Tax in the Foreign Insurance Taxes section.
Tax — Casualty insurance and indemnity bonds (tax box 1)	Number	Enter the computed foreign insurance tax amount for casualty insurance and indemnity bonds that corresponds to this tax entry box.
Tax — Casualty insurance and indemnity bonds (tax box 2)	Number	Enter the computed foreign insurance tax amount for casualty insurance and indemnity bonds that corresponds to this tax entry box. Max length: 3 characters
Premiums paid — Life, sickness and accident policies and annuity contracts	Number	Enter the total premiums paid to foreign insurers for life insurance, sickness and accident policies, and annuity contracts used to calculate the foreign insurance tax.
topmostSubform[0].Page2[0].Table_ForeignInsuranceTaxes[0].IRSno30-2[0].Rate30_2[0].f2_17[0	Text	Enter the rate for the second Foreign Insurance Tax in the Foreign Insurance Taxes section.
Tax — Life, sickness and accident policies (tax box 1)	Number	Enter the computed foreign insurance tax amount for life, sickness and accident policies and annuity contracts that corresponds to this tax entry box.
Tax — Life, sickness and accident policies (tax box 2)	Number	Enter the computed foreign insurance tax amount for life, sickness and accident policies and annuity contracts that corresponds to this tax entry box. Max length: 3 characters
Premiums paid — Reinsurance	Number	Enter the total premiums paid to foreign insurers for reinsurance used to calculate the foreign insurance tax.
topmostSubform[0].Page2[0].Table_ForeignInsuranceTaxes[0].IRsno30-3[0].f2_21[0	Text	Provide additional information required for the foreign insurance taxes for IRS number 30-3.
Tax — Reinsurance (tax box 1)	Number	Enter the computed foreign insurance tax amount for reinsurance that corresponds to this tax entry box.
Tax — Reinsurance (tax box 2)	Number	Enter the computed foreign insurance tax amount for reinsurance that corresponds to this tax entry box. Max length: 3 characters
Fuel Taxes (all fuel-table rows consolidated)
Diesel (removal at terminal rack) — Gallons	Number	Enter the number of gallons of diesel removed at the terminal rack for this line.
Diesel (removal at terminal rack) — Rate	Number	Enter the per‑gallon tax rate that applies to diesel removed at the terminal rack on this line.
Diesel (other taxable events) — Gallons	Number	Enter the number of gallons of diesel involved in taxable events other than removal at the terminal rack.
Diesel (other taxable events) — Rate	Number	Enter the per‑gallon tax rate that applies to diesel for taxable events other than terminal‑rack removal.
Diesel (other taxable events) — Tax (dollars)	Number	Enter the dollar portion of the tax due for the diesel taxable events entered on this line.
Diesel (other taxable events) — Tax (cents)	Number	Enter the cents portion of the tax due for the diesel taxable events entered on this line. Max length: 3 characters
Diesel (biodiesel mixtures) — Gallons	Number	Enter the number of gallons of diesel sold or removed as biodiesel mixture (not at terminal rack).
Diesel (biodiesel mixtures) — Tax	Number	Enter the total tax amount due for the biodiesel mixture gallons reported on this line.
Diesel‑water fuel emulsion — Gallons	Number	Enter the number of gallons of diesel‑water fuel emulsion subject to tax on this line.
topmostSubform[0].Page1[0].Table_FuelTaxes[0].IRSno104[0].f1_39[0	Text	Enter the amount for IRS No. 104 related to fuel taxes.
Diesel‑water fuel emulsion — Tax (dollars)	Number	Enter the dollar portion of the tax due for the diesel‑water fuel emulsion reported on this line.
Diesel‑water fuel emulsion — Tax (cents)	Number	Enter the cents portion of the tax due for the diesel‑water fuel emulsion reported on this line. Max length: 3 characters
Dyed diesel (LUST) — Gallons	Number	Enter the number of gallons of dyed diesel subject to the LUST tax on this line.
topmostSubform[0].Page1[0].Table_FuelTaxes[0].IRSno105[0].Rate105[0	Text	Enter the rate for IRS No. 105 related to fuel taxes.
Dyed diesel (LUST) — Tax (dollars)	Number	Enter the dollar portion of the LUST tax due for the dyed diesel gallons reported on this line.
Dyed diesel (LUST) — Tax (cents)	Number	Enter the cents portion of the LUST tax due for the dyed diesel gallons reported on this line. Max length: 3 characters
Dyed kerosene (LUST) — Gallons	Number	Enter the number of gallons of dyed kerosene subject to the LUST tax on this line.
topmostSubform[0].Page1[0].Table_FuelTaxes[0].IRSno107[0].f1_46[0	Text	Enter the additional amount for IRS No. 107 related to fuel taxes.
Dyed kerosene (LUST) — Tax (dollars)	Number	Enter the dollar portion of the LUST tax due for the dyed kerosene gallons reported on this line.
Dyed kerosene (LUST) — Tax (cents)	Number	Enter the cents portion of the LUST tax due for the dyed kerosene gallons reported on this line. Max length: 3 characters
LUST tax (other exempt removals) — Gallons	Number	Enter the number of gallons for other exempt removals subject to the LUST tax on this line.
topmostSubform[0].Page1[0].Table_FuelTaxes[0].IRSno119[0].f1_50[0	Text	Enter the additional amount for IRS No. 119 related to fuel taxes.
LUST tax (other exempt removals) — Tax (dollars)	Number	Enter the dollar portion of the LUST tax due for the exempt removals reported on this line.
LUST tax (other exempt removals) — Tax (cents)	Number	Enter the cents portion of the LUST tax due for the exempt removals reported on this line. Max length: 3 characters
Kerosene (removal at terminal rack) — Gallons	Number	Enter the number of gallons of kerosene removed at the terminal rack for this line.
Kerosene (removal at terminal rack) — Rate	Number	Enter the per‑gallon tax rate that applies to kerosene removed at the terminal rack on this line.
Kerosene (removal at terminal rack) — Tax	Number	Enter the total tax amount due for the kerosene removed at the terminal rack reported on this line.
topmostSubform[0].Page1[0].Table_FuelTaxes[0].IRSno35b[0].f1_56[0	Text	Enter the amount for IRS No. 35b related to fuel taxes.
Kerosene (other taxable events) — Tax (dollars)	Number	Enter the dollar portion of the tax due for kerosene taxable events other than terminal‑rack removal.
Kerosene (other taxable events) — Tax (cents)	Number	Enter the cents portion of the tax due for kerosene taxable events other than terminal‑rack removal. Max length: 3 characters
Kerosene for use in aviation — Gallons	Number	Enter the number of gallons of kerosene reported for use in aviation on this line.
topmostSubform[0].Page1[0].Table_FuelTaxes[0].IRSno69[0].f1_60[0	Text	Enter the amount for IRS No. 69 related to fuel taxes.
Kerosene for use in aviation — Tax (dollars)	Number	Enter the dollar portion of the tax due for kerosene used in aviation reported on this line.
Kerosene for use in aviation — Tax (cents)	Number	Enter the cents portion of the tax due for kerosene used in aviation reported on this line. Max length: 3 characters
Kerosene for use in commercial aviation — Gallons	Number	Enter the number of gallons of kerosene reported for use in commercial aviation on this line.
topmostSubform[0].Page1[0].Table_FuelTaxes[0].IRSno77[0].f1_64[0	Text	Provide additional information required for IRS number 77 under fuel taxes.
Kerosene for use in commercial aviation — Tax (dollars)	Number	Enter the dollar portion of the tax due for kerosene used in commercial aviation reported on this line.
Kerosene for use in commercial aviation — Tax (cents)	Number	Enter the cents portion of the tax due for kerosene used in commercial aviation reported on this line. Max length: 3 characters
Kerosene, LUST on nontaxable uses — Gallons	Number	Enter the number of gallons of kerosene subject to LUST tax on nontaxable uses for this line.
topmostSubform[0].Page1[0].Table_FuelTaxes[0].IRSno111[0].f1_68[0	Text	Provide additional information required for IRS number 111 under fuel taxes.
Kerosene, LUST on nontaxable uses — Tax (dollars)	Number	Enter the dollar portion of the LUST tax due for kerosene on nontaxable uses reported on this line.
Kerosene, LUST on nontaxable uses — Tax (cents)	Number	Enter the cents portion of the LUST tax due for kerosene on nontaxable uses reported on this line. Max length: 3 characters
Other fuels — Gallons	Number	Enter the number of gallons of other fuels reported on this line, as applicable.
Other fuels — Rate	Number	Enter the per‑gallon tax rate that applies to the other fuels reported on this line.
Other fuels — Tax (dollars)	Number	Enter the dollar portion of the tax due for the other fuels reported on this line.
Other fuels — Tax (cents)	Number	Enter the cents portion of the tax due for the other fuels reported on this line. Max length: 3 characters
Gasoline (removal at terminal rack) — Gallons	Number	Enter the number of gallons of gasoline removed at the terminal rack for this line.
Gasoline (removal at terminal rack) — Rate	Number	Enter the per‑gallon tax rate that applies to gasoline removed at the terminal rack on this line.
Gasoline (other taxable events) — Gallons	Number	Enter the number of gallons of gasoline involved in taxable events other than terminal‑rack removal.
topmostSubform[0].Page1[0].Table_FuelTaxes[0].IRSno62b[0].f1_78[0	Text	Enter the tax amount for IRS number 62b related to fuel taxes.
Gasoline (other taxable events) — Tax (dollars)	Number	Enter the dollar portion of the tax due for the gasoline taxable events reported on this line.
Gasoline (other taxable events) — Tax (cents)	Number	Enter the cents portion of the tax due for the gasoline taxable events reported on this line. Max length: 3 characters
Fractional ownership program fuel — Gallons	Number	Enter the number of gallons of any liquid fuel used in a fractional ownership program aircraft on this line.
Fractional ownership program fuel — Rate	Number	Enter the per‑gallon tax rate that applies to fuel used in a fractional ownership program aircraft.
Fractional ownership program fuel — Tax (dollars)	Number	Enter the dollar portion of the tax due for fractional ownership program fuel reported on this line.
Fractional ownership program fuel — Tax (cents)	Number	Enter the cents portion of the tax due for fractional ownership program fuel reported on this line. Max length: 3 characters
Aviation gasoline — Gallons	Number	Enter the number of gallons of aviation gasoline reported on this line.
topmostSubform[0].Page1[0].Table_FuelTaxes[0].IRSno14[0].f1_86[0	Text	Enter the specific IRS number related to the fuel tax for this entry.
Aviation gasoline — Tax (dollars)	Number	Enter the dollar portion of the tax due for the aviation gasoline gallons reported on this line.
Aviation gasoline — Tax (cents)	Number	Enter the cents portion of the tax due for the aviation gasoline gallons reported on this line. Max length: 3 characters
LPG (liquefied petroleum gas) — Gallons	Number	Enter the number of gallon equivalents of liquefied petroleum gas (LPG) reported on this line.
topmostSubform[0].Page1[0].Table_FuelTaxes[0].IRSno112[0].f1_90[0	Text	Enter the specific IRS number related to the fuel tax for this entry.
LPG (liquefied petroleum gas) — Tax (dollars)	Number	Enter the dollar portion of the tax due for the LPG gallons reported on this line.
LPG (liquefied petroleum gas) — Tax (cents)	Number	Enter the cents portion of the tax due for the LPG gallons reported on this line. Max length: 3 characters
“P Series” fuels — Gallons	Number	Enter the number of gallons of “P Series” fuels reported on this line.
topmostSubform[0].Page1[0].Table_FuelTaxes[0].IRSno118[0].f1_94[0	Text	Enter the amount of tax for IRS number 118 related to fuel taxes.
“P Series” fuels — Tax (dollars)	Number	Enter the dollar portion of the tax due for the “P Series” fuel gallons reported on this line.
“P Series” fuels — Tax (cents)	Number	Enter the cents portion of the tax due for the “P Series” fuel gallons reported on this line. Max length: 3 characters
Compressed natural gas (CNG) — Gallons	Number	Enter the gasoline‑gallon equivalent of compressed natural gas (CNG) reported on this line.
topmostSubform[0].Page1[0].Table_FuelTaxes[0].IRSno120[0].f1_98[0	Text	Enter the amount of tax for IRS number 120 related to fuel taxes.
Compressed natural gas (CNG) — Tax (dollars)	Number	Enter the dollar portion of the tax due for the CNG gallon equivalents reported on this line.
Compressed natural gas (CNG) — Tax (cents)	Number	Enter the cents portion of the tax due for the CNG gallon equivalents reported on this line. Max length: 3 characters
Liquefied hydrogen — Gallons	Number	Enter the number of gallon equivalents of liquefied hydrogen reported on this line.
topmostSubform[0].Page1[0].Table_FuelTaxes[0].IRSno121[0].f1_102[0	Text	Enter additional details for IRS No. 121 related to fuel taxes.
Liquefied hydrogen — Tax (dollars)	Number	Enter the dollar portion of the tax due for the liquefied hydrogen gallon equivalents reported on this line.
Liquefied hydrogen — Tax (cents)	Number	Enter the cents portion of the tax due for the liquefied hydrogen gallon equivalents reported on this line. Max length: 3 characters
Fischer‑Tropsch process fuel — Gallons	Number	Enter the number of gallons of Fischer‑Tropsch process liquid fuel (including peat) reported on this line.
topmostSubform[0].Page1[0].Table_FuelTaxes[0].IRSno122[0].f1_106[0	Text	Enter additional details for IRS No. 122 related to fuel taxes.
Fischer‑Tropsch process fuel — Tax (dollars)	Number	Enter the dollar portion of the tax due for the Fischer‑Tropsch fuel gallons reported on this line.
Fischer‑Tropsch process fuel — Tax (cents)	Number	Enter the cents portion of the tax due for the Fischer‑Tropsch fuel gallons reported on this line. Max length: 3 characters
Liquid fuel derived from biomass — Gallons	Number	Enter the number of gallons of liquid fuel derived from biomass reported on this line.
topmostSubform[0].Page1[0].Table_FuelTaxes[0].IRSno123[0].Rate123[0	Text	Enter the rate for the specific fuel tax being reported.
Liquid fuel derived from biomass — Tax (dollars)	Number	Enter the dollar portion of the tax due for the biomass‑derived fuel gallons reported on this line.
Liquid fuel derived from biomass — Tax (cents)	Number	Enter the cents portion of the tax due for the biomass‑derived fuel gallons reported on this line. Max length: 3 characters
Liquefied natural gas (LNG) — Gallons	Number	Enter the number of gallon equivalents of liquefied natural gas (LNG) reported on this line.
topmostSubform[0].Page1[0].Table_FuelTaxes[0].IRSno124[0].f1_113[0	Text	Enter the rate for another specific fuel tax being reported.
Liquefied natural gas (LNG) — Tax (dollars)	Number	Enter the dollar portion of the tax due for the LNG gallon equivalents reported on this line.
Liquefied natural gas (LNG) — Tax (cents)	Number	Enter the cents portion of the tax due for the LNG gallon equivalents reported on this line. Max length: 3 characters
General Information
Part I Total — Total Tax Due	Number	Enter the total dollar amount of all taxes added in Part I (sum of the amounts entered above).
topmostSubform[0].Page3[0].c3_3[1]_2	CheckBox	Check this box if applicable. This field is a checkbox and should be marked if the condition it represents is true.
topmostSubform[0].Page3[0].c3_4[0]_1	CheckBox	Check this box if applicable. This field is a checkbox and should be marked if the condition it represents is true.
topmostSubform[0].Page5[0].f5_15[0	Text	Enter the specific information required for field 15 on Page 5 of Form 720.
topmostSubform[0].Page5[0].f5_40[0	Text	Enter the specific information required for this field. Refer to the instructions for the exact details needed.
topmostSubform[0].Page5[0].c5_1[0]_1	CheckBox	Check this box if the condition specified in the form instructions applies to you.
topmostSubform[0].Page6[0].f6_47[0	Text	Enter any other relevant information or notes for this section of the form.
topmostSubform[0].Page6[0].c6_1[0]_1	CheckBox	Check this box if the condition specified in this section applies to your business.
topmostSubform[0].Page6[0].c6_2[0]_1	CheckBox	Check this box if applicable.
General Information - Page 4
G	Text	Enter the relevant information for field G on Page 4.
G 5929	Text	Enter the relevant information for field G on Page 4. Max length: 3 characters
topmostSubform[0].Page4[0].f4_15[0	Text	Enter the relevant information for field on Page 4.
topmostSubform[0].Page4[0].f4_16[0	Text	Enter the relevant information for field on Page 4. Max length: 3 characters
Imported chemical substances (line 17)
Line 17 tax amount (dollars)	Number	Enter the dollar portion of the excise tax for imported chemical substances reported on line 17.
Line 17 tax amount (cents)	Text	Enter the cents portion of the excise tax for imported chemical substances reported on line 17 (two digits). Max length: 3 characters
Imported petroleum products oil spill tax (line 21)
Imported petroleum products oil spill tax — dollars	Number	Enter the whole-dollar portion of the imported petroleum products oil spill tax (line 21) for this quarter.
Imported petroleum products oil spill tax — cents	Number	Enter the cents portion of the imported petroleum products oil spill tax (line 21) for this quarter. Max length: 3 characters
Imported petroleum products superfund tax (line 16)
Imported petroleum products superfund tax — tax amount	Number	Enter the tax amount for imported petroleum products superfund tax on line 16.
Imported petroleum products superfund tax — IRS line number	Text	Enter or confirm the IRS line number code associated with this entry (the form’s line number for this tax, typically “16”). Max length: 3 characters
IRS Number 125 Details
LUST fuel gallons	Number	Enter the total number of gallons of inland waterways fuel subject to the LUST tax for the reporting period.
LUST tax rate	Number	Enter the LUST tax rate applied per gallon for inland waterways fuel (expressed as a decimal or decimal fraction).
IRS Number 125 Tax Amount
LUST tax amount (Line 125)	Number	Enter the total LUST (Leaking Underground Storage Tank) tax amount due for inland waterways fuel use shown on line 125 as a numeric value in dollars (include cents if applicable).
IRS Number 125 Tax Code
topmostSubform[0].Page2[0].IRSno64-20Table[0].IRSno125[0].Tax125[0].f2_104[0	Text	Enter the tax code associated with IRS number 125 for the first entry in the table on Page 2. The code should be a maximum of 3 characters. Max length: 3 characters
IRS Number 51 Details
topmostSubform[0].Page2[0].IRSno64-20Table[0].IRSno51[0].f2_105[0	Text	Enter the specific details related to IRS number 51 for the first entry in the table on Page 2.
IRS Number 64 Details
Number of gallons (Inland waterways fuel use)	Number	Enter the total number of gallons of fuel used on inland waterways for the reporting period.
Tax due for inland waterways fuel use	Number	Enter the tax amount owed for the inland waterways fuel use line (calculated from the gallons and the applicable rate).
IRS Number 64 Tax Amount
topmostSubform[0].Page2[0].IRSno64-20Table[0].IRSno64[0].Tax64[0].f2_99[0	Text	Enter the tax amount associated with IRS number 64 for the first entry in the table on Page 2.
IRS Number 64 Tax Code
Inland Waterways Fuel Use Tax (IRS No. 64) - Tax	Number	Enter the tax amount owed for IRS No. 64 (Inland waterways fuel use tax) for the reported number of gallons. Max length: 3 characters
IRS Numbers
IRS number — Total / Reserved	Text	Enter the IRS numeric identifier associated with the Total/Reserved for future use line in Part I.
Line 12a Amount of Claim
topmostSubform[0].Page7[0].Table_Line12[0].Line12a[0].AmountOfClaim[0].f7_5[0	Text	Enter the amount of claim for Line 12a on Page 7.
topmostSubform[0].Page7[0].Table_Line12[0].Line12a[0].AmountOfClaim[0].f7_6[0	Text	Enter the amount of claim for Line 12a on Page 7. Maximum length is 3 characters. Max length: 3 characters
Line 12a Details
topmostSubform[0].Page7[0].Table_Line12[0].Line12a[0].f7_3[0	Text	Enter the specific detail required for Line 12a, field 1 on Page 7.
topmostSubform[0].Page7[0].Table_Line12[0].Line12a[0].f7_4[0	Text	Enter the specific detail required for Line 12a, field 2 on Page 7.
topmostSubform[0].Page7[0].Table_Line12[0].Line12a[0].f7_7[0	Text	Enter the specific detail required for Line 12a, field 3 on Page 7.
Line 12b Amount of Claim
topmostSubform[0].Page7[0].Table_Line12[0].Line12b[0].AmountOfClaim[0].f7_10[0	Text	Enter the amount of claim for Line 12b on Page 7.
topmostSubform[0].Page7[0].Table_Line12[0].Line12b[0].AmountOfClaim[0].f7_11[0	Text	Enter the amount of claim for Line 12b on Page 7. Maximum length is 3 characters. Max length: 3 characters
Line 12b Details
topmostSubform[0].Page7[0].Table_Line12[0].Line12b[0].f7_8[0	Text	Enter the specific detail required for Line 12b, field 1 on Page 7.
topmostSubform[0].Page7[0].Table_Line12[0].Line12b[0].f7_9[0	Text	Enter the specific detail required for Line 12b, field 2 on Page 7.
topmostSubform[0].Page7[0].Table_Line12[0].Line12b[0].f7_12[0	Text	Enter the specific detail required for Line 12b, field 3 on Page 7.
Line 1b Details
topmostSubform[0].Page5[0].Table_Line1[0].LIne1b[0].f5_10[0	Text	Enter the specific information required for Line 1b, field 10 on Page 5 of Form 720.
topmostSubform[0].Page5[0].Table_Line1[0].LIne1b[0].f5_11[0	Text	Enter the specific information required for Line 1b, field 11 on Page 5 of Form 720.
topmostSubform[0].Page5[0].Table_Line1[0].LIne1b[0].AmountOfClaim[0].f5_12[0	Text	Enter the amount of claim for Line 1b, field 12 on Page 5 of Form 720.
topmostSubform[0].Page5[0].Table_Line1[0].LIne1b[0].AmountOfClaim[0].f5_13[0	Text	Enter the amount of claim for Line 1b, field 13 on Page 5 of Form 720. Note: Maximum length is 3 characters. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line1[0].LIne1b[0].f5_14[0	Text	Enter the specific information required for Line 1b, field 14 on Page 5 of Form 720.
Line 2a Details
topmostSubform[0].Page5[0].Table_Line2[0].Line2a[0].f5_16[0	Text	Enter the specific information required for Line 2a, field 16 on Page 5 of Form 720.
topmostSubform[0].Page5[0].Table_Line2[0].Line2a[0].f5_17[0	Text	Enter the specific information required for Line 2a, field 17 on Page 5 of Form 720.
topmostSubform[0].Page5[0].Table_Line2[0].Line2a[0].f5_18[0	Text	Enter the specific information required for Line 2a, field 18 on Page 5 of Form 720.
topmostSubform[0].Page5[0].Table_Line2[0].Line2a[0].AmountOfClaim[0].f5_19[0	Text	Enter the amount of claim for Line 2a, field 19 on Page 5 of Form 720.
Line 3a Details
topmostSubform[0].Page5[0].Table_Line3[0].Line3a[0].f5_41[0	Text	Provide the detailed information for Line 3a as specified in the form instructions.
topmostSubform[0].Page5[0].Table_Line3[0].Line3a[0].f5_42[0	Text	Provide the detailed information for Line 3a as specified in the form instructions.
topmostSubform[0].Page5[0].Table_Line3[0].Line3a[0].f5_43[0	Text	Provide the detailed information for Line 3a as specified in the form instructions.
topmostSubform[0].Page5[0].Table_Line3[0].Line3a[0].AmountOfClaim[0].f5_44[0	Text	Enter the amount of claim for Line 3a as specified in the form instructions.
topmostSubform[0].Page5[0].Table_Line3[0].Line3a[0].AmountOfClaim[0].f5_45[0	Text	Enter the amount of claim for Line 3a as specified in the form instructions. Note that this field has a maximum length of 3 characters. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line3[0].Line3a[0].f5_46[0	Text	Provide the detailed information for Line 3a as specified in the form instructions.
Line 3b Details
topmostSubform[0].Page5[0].Table_Line3[0].Line3b[0].f5_47[0	Text	Provide the detailed information for Line 3b as specified in the form instructions.
topmostSubform[0].Page5[0].Table_Line3[0].Line3b[0].f5_48[0	Text	Provide the detailed information for Line 3b as specified in the form instructions.
Line 4b Amount of Claim
topmostSubform[0].Page5[0].Table_Line4[0].Line4b[0].AmountOfClaim[0].f5_81[0	Text	Enter the amount of claim for Line 4b on Page 5.
topmostSubform[0].Page5[0].Table_Line4[0].Line4b[0].AmountOfClaim[0].f5_82[0	Text	Enter the amount of claim for Line 4b on Page 5. Maximum length is 3 characters. Max length: 3 characters
Line 4b Details
topmostSubform[0].Page5[0].Table_Line4[0].Line4b[0].f5_78[0	Text	Enter the specific information required for Line 4b, field 78 on Page 5.
topmostSubform[0].Page5[0].Table_Line4[0].Line4b[0].f5_79[0	Text	Enter the specific information required for Line 4b, field 79 on Page 5.
topmostSubform[0].Page5[0].Table_Line4[0].Line4b[0].f5_80[0	Text	Enter the specific information required for Line 4b, field 80 on Page 5.
topmostSubform[0].Page5[0].Table_Line4[0].Line4b[0].f5_83[0	Text	Enter the specific information required for Line 4b, field 83 on Page 5.
Line 4c Amount of Claim
topmostSubform[0].Page5[0].Table_Line4[0].Line4c[0].AmountOfClaim[0].f5_87[0	Text	Enter the amount of claim for Line 4c on Page 5.
Line 4c Details
topmostSubform[0].Page5[0].Table_Line4[0].Line4c[0].f5_84[0	Text	Enter the specific information required for Line 4c, field 84 on Page 5.
topmostSubform[0].Page5[0].Table_Line4[0].Line4c[0].f5_85[0	Text	Enter the specific information required for Line 4c, field 85 on Page 5.
topmostSubform[0].Page5[0].Table_Line4[0].Line4c[0].f5_86[0	Text	Enter the specific information required for Line 4c, field 86 on Page 5.
Line 4e Details
topmostSubform[0].Page5[0].Table_Line4[0].Line4e[0].f5_98[0	Text	Enter the specific details related to Line 4e on Page 5 of Form 720.
topmostSubform[0].Page5[0].Table_Line4[0].Line4e[0].AmountOfClaim[0].f5_99[0	Text	Enter the amount of claim for Line 4e on Page 5 of Form 720.
topmostSubform[0].Page5[0].Table_Line4[0].Line4e[0].AmountOfClaim[0].f5_100[0	Text	Enter the amount of claim for Line 4e on Page 5 of Form 720. The value should be a maximum of 3 characters. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line4[0].Line4e[0].Ln377[0	Text	Enter additional information or notes related to Line 4e on Page 5 of Form 720.
Line 4f Details
topmostSubform[0].Page5[0].Table_Line4[0].Line4f[0].f5_101[0	Text	Enter the specific details related to Line 4f on Page 5 of Form 720.
topmostSubform[0].Page5[0].Table_Line4[0].Line4f[0].f5_102[0	Text	Enter the specific details related to Line 4f on Page 5 of Form 720.
topmostSubform[0].Page5[0].Table_Line4[0].Line4f[0].f5_103[0	Text	Enter the specific details related to Line 4f on Page 5 of Form 720.
topmostSubform[0].Page5[0].Table_Line4[0].Line4f[0].AmountOfClaim[0].f5_104[0	Text	Enter the amount of claim for Line 4f on Page 5 of Form 720.
topmostSubform[0].Page5[0].Table_Line4[0].Line4f[0].AmountOfClaim[0].f5_105[0	Text	Enter the amount of claim for Line 4f on Page 5 of Form 720. The value should be a maximum of 3 characters. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line4[0].Line4f[0].f5_106[0	Text	Enter the specific details related to Line 4f on Page 5 of Form 720.
Line 5a Details
topmostSubform[0].Page5[0].f5_107[0	Text	Enter the specific information required for Line 5a on Page 5 of Form 720.
topmostSubform[0].Page5[0].Table_Line5[0].Line5a[0].f5_108[0	Text	Provide the detailed information for the first part of Line 5a on Page 5 of Form 720.
topmostSubform[0].Page5[0].Table_Line5[0].Line5a[0].f5_109[0	Text	Enter the required details for the second part of Line 5a on Page 5 of Form 720.
topmostSubform[0].Page5[0].Table_Line5[0].Line5a[0].f5_110[0	Text	Fill in the necessary information for the third part of Line 5a on Page 5 of Form 720.
topmostSubform[0].Page5[0].Table_Line5[0].Line5a[0].AmountOfClaim[0].f5_111[0	Text	Enter the amount of claim for Line 5a on Page 5 of Form 720.
topmostSubform[0].Page5[0].Table_Line5[0].Line5a[0].AmountOfClaim[0].f5_112[0	Text	Provide the amount of claim for Line 5a on Page 5 of Form 720. The maximum length is 3 characters. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line5[0].Line5a[0].f5_113[0	Text	Enter the additional information required for Line 5a on Page 5 of Form 720.
Line 5b Details
topmostSubform[0].Page5[0].Table_Line5[0].Line5b[0].f5_114[0	Text	Provide the specific information required for Line 5b on Page 5 of Form 720.
topmostSubform[0].Page5[0].Table_Line5[0].Line5b[0].f5_115[0	Text	Enter the detailed information for the first part of Line 5b on Page 5 of Form 720.
topmostSubform[0].Page5[0].Table_Line5[0].Line5b[0].f5_116[0	Text	Fill in the necessary details for the second part of Line 5b on Page 5 of Form 720.
Line 6e Details
topmostSubform[0].Page6[0].Table_Line6[0].Line6e[0].f6_28[0	Text	Enter the specific information required for Line 6e on Page 6 of Form 720.
Line 6f Amount of Claim
topmostSubform[0].Page6[0].Table_Line6[0].Line6f[0].AmountOfClaim[0].f6_32[0	Text	Enter the amount of claim for Line 6f on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line6[0].Line6f[0].AmountOfClaim[0].f6_33[0	Text	Enter the amount of claim for Line 6f on Page 6 of Form 720. Maximum length is 3 characters. Max length: 3 characters
Line 6f Details
topmostSubform[0].Page6[0].Table_Line6[0].Line6f[0].f6_29[0	Text	Enter the specific information required for Line 6f on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line6[0].Line6f[0].f6_30[0	Text	Enter the specific information required for Line 6f on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line6[0].Line6f[0].f6_31[0	Text	Enter the specific information required for Line 6f on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line6[0].Line6f[0].f6_34[0	Text	Enter the specific information required for Line 6f on Page 6 of Form 720.
Line 6g Details
topmostSubform[0].Page6[0].Table_Line6[0].Line6g[0].f6_35[0	Text	Enter the specific information required for Line 6g on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line6[0].Line6g[0].f6_36[0	Text	Enter the specific information required for Line 6g on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line6[0].Line6g[0].f6_37[0	Text	Enter the specific information required for Line 6g on Page 6 of Form 720.
Line 8b Details
topmostSubform[0].Page6[0].Table_Line8[0].Line8b[0].f6_67[0	Text	Enter the specific details related to Line 8b on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line8[0].Line8b[0].AmountOfClaim[0].f6_68[0	Text	Enter the amount of claim for Line 8b on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line8[0].Line8b[0].AmountOfClaim[0].f6_69[0	Text	Enter the amount of claim for Line 8b on Page 6 of Form 720. The value should be a 3-digit number. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line8[0].Line8b[0].f6_70[0	Text	Enter the specific details related to Line 8b on Page 6 of Form 720.
Line 8c Details
topmostSubform[0].Page6[0].Table_Line8[0].Line8c[0].f6_71[0	Text	Enter the specific details related to Line 8c on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line8[0].Line8c[0].f6_72[0	Text	Enter the specific details related to Line 8c on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line8[0].Line8c[0].AmountOfClaim[0].f6_73[0	Text	Enter the amount of claim for Line 8c on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line8[0].Line8c[0].AmountOfClaim[0].f6_74[0	Text	Enter the amount of claim for Line 8c on Page 6 of Form 720. The value should be a 3-digit number. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line8[0].Line8c[0].f6_75[0	Text	Enter the specific details related to Line 8c on Page 6 of Form 720.
Manufacturers Taxes
Coal — Underground mined: Number of tons (line 36)	Number	Enter the total number of tons of underground‑mined coal subject to the manufacturer's tax for line 36.
Coal — Underground mined: Sales price (line 36)	Number	Enter the sales price used to calculate the per‑ton tax for underground‑mined coal on line 36 (dollars and cents).
topmostSubform[0].Page2[0].Table_ManufacturersTaxes[0].IRSno36[0].f2_26[0	Text	Enter the tax amount for the manufacturers taxes for IRS number 36.
Coal — Underground mined: Tax dollars (line 36)	Number	Enter the whole‑dollar portion of the tax calculated for underground‑mined coal at the rate shown on line 36.
Coal — Underground mined: Tax cents (line 36)	Number	Enter the cents portion of the tax calculated for underground‑mined coal at the rate shown on line 36. Max length: 3 characters
Coal — Underground mined (percent type): Number of tons (line 37)	Number	Enter the number of tons of underground‑mined coal used to calculate the 4.4% of sales‑price tax reported on line 37.
Coal — Surface mined: Number of tons (line 38)	Number	Enter the total number of tons of surface‑mined coal subject to the manufacturer's tax for line 38.
Coal — Surface mined: Sales price (line 38)	Number	Enter the sales price used to calculate the per‑ton tax for surface‑mined coal on line 38 (dollars and cents).
topmostSubform[0].Page2[0].Table_ManufacturersTaxes[0].IRSno39[0].f2_41[0	Text	Enter the amount for IRS No. 39 related to manufacturers taxes.
Coal — Surface mined: Tax dollars (line 39)	Number	Enter the whole‑dollar portion of the tax calculated for surface‑mined coal at the applicable rate reported on line 39.
Coal — Surface mined: Tax cents (line 39)	Number	Enter the cents portion of the tax calculated for surface‑mined coal at the applicable rate reported on line 39. Max length: 3 characters
Manufacturers' Taxes
Sales price — Coal (underground)	Number	Enter the sales price used to calculate the tax for underground-mined coal.
topmostSubform[0].Page2[0].Table_ManufacturersTaxes[0].IRSno37[0].f2_31[0	Text	Provide additional details required for IRS No. 37 under manufacturers' taxes.
Tax amount — Coal (underground)	Number	Enter the tax amount due for underground-mined coal.
IRS number — Coal (underground)	Text	Enter the IRS line or reference number associated with underground-mined coal. Max length: 3 characters
Number of tons — Coal (surface)	Number	Enter the total number of tons of surface-mined coal subject to tax.
Sales price — Coal (surface)	Number	Enter the sales price used to calculate the tax for surface-mined coal.
topmostSubform[0].Page2[0].Table_ManufacturersTaxes[0].IRSno38[0].f2_36[0	Text	Input the tax amount associated with IRS No. 38 for manufacturers' taxes.
Tax amount — Coal (surface)	Number	Enter the tax amount due for surface-mined coal.
IRS number — Coal (surface)	Text	Enter the IRS line or reference number associated with surface-mined coal. Max length: 3 characters
Monthly Tax Amounts
topmostSubform[0].Page4[0].Table_SchA_2a[0].FirstMonth[0].SixteenthThruLast[0].f4_20[0	Text	Enter the excise tax amount for the first month, from the 16th to the last day of the month. Max length: 3 characters
topmostSubform[0].Page4[0].Table_SchA_2a[0].SecondMonth[0].FirstThru15[0].f4_21[0	Text	Enter the excise tax amount for the second month, from the 1st to the 15th day of the month.
topmostSubform[0].Page4[0].Table_SchA_2a[0].SecondMonth[0].FirstThru15[0].f4_22[0	Text	Enter the excise tax amount for the second month, from the 1st to the 15th day of the month. Max length: 3 characters
topmostSubform[0].Page4[0].Table_SchA_2a[0].SecondMonth[0].SixteenthThruLast[0].f4_23[0	Text	Enter the excise tax amount for the second month, from the 16th to the last day of the month.
topmostSubform[0].Page4[0].Table_SchA_2a[0].SecondMonth[0].SixteenthThruLast[0].f4_24[0	Text	Enter the excise tax amount for the second month, from the 16th to the last day of the month. Max length: 3 characters
topmostSubform[0].Page4[0].Table_SchA_2a[0].ThirdMonth[0].FirstThru15[0].f4_25[0	Text	Enter the excise tax amount for the third month, from the 1st to the 15th day of the month.
topmostSubform[0].Page4[0].Table_SchA_2a[0].ThirdMonth[0].FirstThru15[0].f4_26[0	Text	Enter the excise tax amount for the third month, from the 1st to the 15th day of the month. Max length: 3 characters
topmostSubform[0].Page4[0].Table_SchA_2a[0].ThirdMonth[0].SixteenthThruLast[0].f4_27[0	Text	Enter the excise tax amount for the third month, from the 16th to the last day of the month.
topmostSubform[0].Page4[0].Table_SchA_2a[0].ThirdMonth[0].SixteenthThruLast[0].f4_28[0	Text	Enter the amount for the third month from the 16th to the last day for Schedule A, line 2a. Max length: 3 characters
topmostSubform[0].Page4[0].f4_29[0	Text	Enter the total amount for Schedule A, line 2a.
topmostSubform[0].Page4[0].f4_30[0	Text	Enter the amount for the third month from the 16th to the last day for Schedule A, line 2b. Max length: 3 characters
topmostSubform[0].Page4[0].f4_31[0	Text	Enter the total amount for Schedule A, line 2b.
topmostSubform[0].Page4[0].f4_32[0	Text	Enter the amount for the third month from the 16th to the last day for Schedule A, line 2c. Max length: 3 characters
ODC tax on imported products (line 19)
ODC imported products — Tax amount	Number	Enter the total tax amount owed for ozone‑depleting chemicals (ODCs) imported during the quarter for line 19.
ODC imported products — IRS number	Text	Enter the IRS line number associated with this tax entry (the preprinted line number for ODC tax on imported products). Max length: 3 characters
ODCs (line 98)
Line 98 — ODCs tax amount	Number	Enter the excise tax amount for ozone‑depleting chemicals (ODCs) reported on line 98 of Form 720 as a numeric value.
Line reference code for ODCs	Number	Enter the small numeric reference code or IRS line identifier associated with the ODCs entry on line 98. Max length: 3 characters
Other Excise Tax
Amount of obligations	Text	Enter the total number of obligations not in registered form for this reporting line.
topmostSubform[0].Page2[0].Table_OtherExcise[0].BodyRow[0].f2_9[0	Text	Enter the tax amount for the Other Excise Tax section.
Tax on obligations	Number	Enter the tax amount in dollars calculated for the obligations at the rate shown for this line.
Other Excise Taxes
topmostSubform[0].Page2[0].Table_OtherExcise[0].BodyRow[0].Tax31[0].f2_11[0	Text	Enter the amount for Tax 31 in the Other Excise Taxes section. Max length: 3 characters
Preparer Information
Print/Type preparer's name	Text	Print or type the name of the preparer. This is the name of the individual who prepared the form.
topmostSubform[0].Page3[0].f3_26[0	Text	Enter the preparer's PTIN (Preparer Tax Identification Number). This is an 11-digit number assigned to tax preparers. Max length: 11 characters
Firm's name	Text	Enter the name of the firm. This is the name of the company or firm that the preparer is associated with.
Firm's name 6cac	Text	Enter the name of the firm. This is the name of the company or firm that the preparer is associated with.
Firm's EIN	Text	Enter the firm's EIN (Employer Identification Number). This is a 10-digit number assigned to the firm by the IRS. Max length: 10 characters
Phone no	Text	Enter the phone number of the firm. This is the contact number for the firm associated with the preparer.
Quarterly Information
topmostSubform[0].Page8[0].Line3_ReadOrder[0].Quarter_ReadOrder[0].c8_1[0]_1	CheckBox	Check this box if it applies to the first quarter.
topmostSubform[0].Page8[0].Line3_ReadOrder[0].Quarter_ReadOrder[0].c8_1[1]_2	CheckBox	Check this box if it applies to the second quarter.
topmostSubform[0].Page8[0].Line3_ReadOrder[0].c8_1[0]_3	CheckBox	Check this box if it applies to the third quarter.
topmostSubform[0].Page8[0].Line3_ReadOrder[0].c8_1[1]_4	CheckBox	Check this box if it applies to the fourth quarter.
Retail Tax
Retail Tax — Dollars	Number	Enter the dollar portion of the total retail tax due for trucks, trailers, semitrailer chassis and bodies, and tractors at the 12% rate.
Retail Tax — Cents	Number	Enter the cents portion of the total retail tax due for trucks, trailers, semitrailer chassis and bodies, and tractors at the 12% rate. Max length: 3 characters
Retail Taxes
Retail Tax - Tax Due	Number	Enter the dollar amount of retail excise tax owed for trucks, trailers, semitrailer chassis and bodies, and tractors, as computed at the applicable rate.
Sales Information
Sales price — Item 1	Number	Enter the sales price amount for the first item listed in Part I (Sales price for the reserved/future-use line).
Sales price — Item 2	Number	Enter the sales price amount for the second item listed in Part I (Sales price for the reserved/future-use line). Max length: 3 characters
Schedule A-1a - First Month
topmostSubform[0].Page4[0].Table_SchA-1a[0].FirstMonth[0].FirstThru15[0].f4_2[0	Text	Enter the amount for the first through fifteenth day of the first month in Schedule A-1a. Max length: 3 characters
topmostSubform[0].Page4[0].Table_SchA-1a[0].FirstMonth[0].SixteenthThruLast[0].f4_3[0	Text	Enter the amount for the sixteenth through last day of the first month in Schedule A-1a.
topmostSubform[0].Page4[0].Table_SchA-1a[0].FirstMonth[0].SixteenthThruLast[0].f4_4[0	Text	Enter the amount for the sixteenth through last day of the first month in Schedule A-1a. Max length: 3 characters
Schedule A-1a - Second Month
topmostSubform[0].Page4[0].Table_SchA-1a[0].SecondMonth[0].FirstThru15[0].f4_5[0	Text	Enter the amount for the first through fifteenth day of the second month in Schedule A-1a.
topmostSubform[0].Page4[0].Table_SchA-1a[0].SecondMonth[0].FirstThru15[0].f4_6[0	Text	Enter the amount for the first through fifteenth day of the second month in Schedule A-1a. Max length: 3 characters
topmostSubform[0].Page4[0].Table_SchA-1a[0].SecondMonth[0].SixteenthThruLast[0].f4_7[0	Text	Enter the amount for the sixteenth through last day of the second month in Schedule A-1a.
topmostSubform[0].Page4[0].Table_SchA-1a[0].SecondMonth[0].SixteenthThruLast[0].f4_8[0	Text	Enter the amount for the sixteenth through last day of the second month in Schedule A-1a. Max length: 3 characters
Schedule A-1a - Third Month
topmostSubform[0].Page4[0].Table_SchA-1a[0].ThirdMonth[0].FirstThru15[0].f4_9[0	Text	Enter the amount for the first through fifteenth day of the third month in Schedule A-1a.
topmostSubform[0].Page4[0].Table_SchA-1a[0].ThirdMonth[0].FirstThru15[0].f4_10[0	Text	Enter the amount for the first through fifteenth day of the third month for Schedule A-1a. Max length: 3 characters
topmostSubform[0].Page4[0].Table_SchA-1a[0].ThirdMonth[0].SixteenthThruLast[0].f4_11[0	Text	Enter the amount for the sixteenth through last day of the third month for Schedule A-1a.
topmostSubform[0].Page4[0].Table_SchA-1a[0].ThirdMonth[0].SixteenthThruLast[0].f4_12[0	Text	Enter the amount for the sixteenth through last day of the third month for Schedule A-1a. Max length: 3 characters
Schedule A-2a - First Month
topmostSubform[0].Page4[0].Table_SchA_2a[0].FirstMonth[0].FirstThru15[0].f4_17[0	Text	Enter the amount for the first through fifteenth day of the first month for Schedule A-2a.
topmostSubform[0].Page4[0].Table_SchA_2a[0].FirstMonth[0].FirstThru15[0].f4_18[0	Text	Enter the amount for the first through fifteenth day of the first month for Schedule A-2a. Max length: 3 characters
topmostSubform[0].Page4[0].Table_SchA_2a[0].FirstMonth[0].SixteenthThruLast[0].f4_19[0	Text	Enter the amount for the sixteenth through last day of the first month for Schedule A-2a.
Ship Passenger Tax
Number of persons	Number	Enter the total number of passengers transported by water for which the ship passenger tax is being reported.
topmostSubform[0].Page2[0].Table_ShipPassengerTax[0].IRSno29[0].f2_5[0	Text	Enter the tax amount for the Ship Passenger Tax section.
Tax amount (Ship Passenger Tax)	Number	Enter the total tax due for ship passengers, calculated as the number of persons multiplied by $3.00 per person.
IRS number/code	Text	Enter the IRS line number or code that identifies this tax on the form (typically '29' for Ship Passenger Tax). Max length: 3 characters
Signature Information
Type or print name below signature	Text	Type or print the name of the person signing the form. This should be the name of the individual who is authorized to sign the return.
topmostSubform[0].Page3[0].f3_23[0	Text	Enter the date the form is signed. This field is for the date on which the form is officially signed.
Specific Taxes
Gas guzzler tax — Check if one-time filing	Checkbox	Check this box if you are filing the gas guzzler tax (attach Form 6197) and this return is a one-time filing for that tax.
Gas guzzler tax — Tax amount	Number	Enter the tax amount due for the gas guzzler tax (attach Form 6197 if required) to report on this line.
Gas guzzler tax — IRS reference number	Text	Enter the IRS reference or line number associated with the gas guzzler tax entry (if required). Max length: 3 characters
Vaccines — Tax amount	Number	Enter the tax amount due for vaccines to report on this line.
Vaccines — IRS reference number	Text	Enter the IRS reference or line number associated with the vaccines tax entry (if required). Max length: 3 characters
Tax Amounts
Tax amount — self‑insured (plan ending before Oct 1, 2023)	Number	Enter the tax amount owed for the self‑insured health plan line with a plan year ending before October 1, 2023.
Average lives covered — self‑insured (plan ending before Oct 1, 2023)	Text	Enter the average number of lives covered by the applicable self‑insured health plan for the plan year ending before October 1, 2023.
topmostSubform[0].Page2[0].PartIITable[0].BodyRow5[0].f2_71[0	Text	Enter the specific tax amount for the category listed in row 5 of Part II on Page 2.
PCORI fee — self‑insured (plan ending before Oct 1, 2023)	Number	Enter the Patient‑Centered Outcomes Research fee calculated for the self‑insured plan with a plan year ending before October 1, 2023.
Average lives covered — self‑insured (plan ending on or after Oct 1, 2023)	Text	Enter the average number of lives covered by the applicable self‑insured health plan for the plan year ending on or after October 1, 2023 and before October 1, 2024.
topmostSubform[0].Page2[0].PartIITable[0].BodyRow6[0].f2_74[0	Text	Enter the specific tax amount for the category listed in row 6 of Part II on Page 2.
PCORI fee — self‑insured (plan ending on or after Oct 1, 2023)	Number	Enter the Patient‑Centered Outcomes Research fee calculated for the self‑insured plan with a plan year ending on or after October 1, 2023 and before October 1, 2024.
Tax amount — Sport fishing equipment	Number	Enter the tax amount owed for sport fishing equipment (line 41).
IRS line number — Sport fishing equipment	Text	Enter the IRS line number associated with the sport fishing equipment line as shown on the form. Max length: 3 characters
Tax Calculation
3 3 Total tax. Add Part I, line 1, and Part II, line 2	Text	Enter the total tax amount by adding the amounts from Part I, line 1, and Part II, line 2.
6	Text	Enter the total amount for the specific excise tax being reported.
Tax Details
topmostSubform[0].Page2[0].IRSno41-140Table[0].IRSno110[0].f2_79[0	Text	Enter the specific tax amount for IRS number 110.
Tax — Fishing rods and fishing poles (Line 110)	Number	Enter the tax amount for fishing rods and fishing poles for this reporting period.
IRS reference — Fishing rods and fishing poles (Line 110)	Text	Enter the IRS reference number or code associated with the fishing rods and fishing poles tax line (for example, 110). Max length: 3 characters
topmostSubform[0].Page2[0].IRSno41-140Table[0].IRSno42[0].f2_82[0	Text	Enter the specific tax amount for IRS number 42.
Tax — Electric outboard motors (Line 42)	Number	Enter the tax amount for electric outboard motors for this reporting period.
IRS reference — Electric outboard motors (Line 42)	Text	Enter the IRS reference number or code associated with the electric outboard motors tax line (for example, 42). Max length: 3 characters
topmostSubform[0].Page2[0].IRSno41-140Table[0].IRSno114[0].f2_85[0	Text	Enter the specific tax amount for IRS number 114.
Tax — Fishing tackle boxes (Line 114)	Number	Enter the tax amount for fishing tackle boxes for this reporting period.
IRS reference — Fishing tackle boxes (Line 114)	Text	Enter the IRS reference number or code associated with the fishing tackle boxes tax line (for example, 114). Max length: 3 characters
Tax — Repurchase of corporate stock (Line 150)	Number	Enter the tax amount for repurchase of corporate stock reported on this line. Max length: 3 characters
Tax — Sales of designated drugs during statutory periods (Line 142)	Number	Enter the tax amount for sales of designated drugs during statutory periods for this reporting period.
IRS reference — Sales of designated drugs (Line 142)	Text	Enter the IRS reference number or code associated with the sales of designated drugs tax line (for example, 142). Max length: 3 characters
Total tax — Part II	Number	Enter the total tax amount for Part II (sum of all Part II line tax amounts).
IRS reference — Part II total	Text	Enter the IRS reference number or code associated with the Part II total, if applicable. Max length: 3 characters
topmostSubform[0].Page3[0].f3_2[0	Text	Enter the specific code related to the type of excise tax being reported. Max length: 3 characters
topmostSubform[0].Page3[0].f3_3[0	Text	Provide additional details or descriptions related to the excise tax being reported.
topmostSubform[0].Page3[0].f3_5[0	Text	Provide additional details or descriptions related to the excise tax being reported.
topmostSubform[0].Page3[0].f3_6[0	Text	Enter the specific code related to the type of excise tax being reported. Max length: 3 characters
topmostSubform[0].Page3[0].c3_1[0]_1	CheckBox	Check this box if applicable to the specific excise tax being reported.
6 c05c	Text	Enter the specific code related to the type of excise tax being reported. Max length: 3 characters
topmostSubform[0].Page5[0].Table_Line5[0].Line5d[0].f5_127[0	Text	Enter the specific detail required for Line 5d of the form. This could be related to a particular type of excise tax or claim.
topmostSubform[0].Page5[0].Table_Line5[0].Line5d[0].f5_128[0	Text	Provide additional information or details required for Line 5d of the form. This may pertain to a specific tax or claim.
topmostSubform[0].Page5[0].Table_Line5[0].Line5d[0].f5_131[0	Text	Provide any additional information or details required for Line 5d. This may include specific tax details or claim information.
topmostSubform[0].Page5[0].Table_Line5[0].Line5e[0].f5_132[0	Text	Enter the specific detail required for Line 5e of the form. This could be related to a particular type of excise tax or claim.
topmostSubform[0].Page5[0].Table_Line5[0].Line5e[0].f5_133[0	Text	Provide additional information or details required for Line 5e of the form. This may pertain to a specific tax or claim.
topmostSubform[0].Page5[0].Table_Line5[0].Line5e[0].f5_134[0	Text	Provide any additional information or details required for Line 5e. This may include specific tax details or claim information.
topmostSubform[0].Page5[0].Table_Line5[0].Line5e[0].f5_137[0	Text	Enter the specific information required for Line 5e on Page 5 of Form 720.
topmostSubform[0].Page6[0].Table_Line6[0].Line6a[0].f6_1[0	Text	Enter the specific information required for Line 6a on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line6[0].Line6a[0].Rate183A[0	Text	Enter the rate for Line 6a on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line6[0].Line6a[0].f6_2[0	Text	Enter the specific information required for Line 6a on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line6[0].Line6a[0].Ln419[0	Text	Enter the specific information required for Line 6a on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line6[0].Line6b[0].f6_5[0	Text	Enter the specific information required for Line 6b on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line6[0].Line6b[0].f6_6[0	Text	Enter the specific information required for Line 6b on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line6[0].Line6b[0].f6_7[0	Text	Enter the specific information required for Line 6b on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line7[0].Line7a[0].f6_49[0	Text	Provide the detailed information required for Line 7a, as specified in the form instructions.
topmostSubform[0].Page6[0].Table_Line7[0].Line7a[0].f6_50[0	Text	Provide the detailed information required for Line 7a, as specified in the form instructions.
topmostSubform[0].Page6[0].Table_Line7[0].Line7a[0].AmountOfClaim[0].f6_51[0	Text	Enter the amount of claim for Line 7a as specified in the form instructions.
topmostSubform[0].Page6[0].Table_Line7[0].Line7a[0].AmountOfClaim[0].f6_52[0	Text	Enter the amount of claim for Line 7a. The value must be a number with a maximum length of 3 digits. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line7[0].Line7a[0].f6_53[0	Text	Provide the detailed information required for Line 7a, as specified in the form instructions.
topmostSubform[0].Page6[0].Table_Line7[0].Line7b[0].f6_54[0	Text	Provide the detailed information required for Line 7b, as specified in the form instructions.
topmostSubform[0].Page6[0].Table_Line7[0].Line7b[0].f6_55[0	Text	Provide the detailed information required for Line 7b, as specified in the form instructions.
topmostSubform[0].Page6[0].Table_Line7[0].Line7b[0].AmountOfClaim[0].f6_56[0	Text	Enter the amount of claim for Line 7b as specified in the form instructions.
topmostSubform[0].Page6[0].Table_Line9[0].Line9a[0].f6_77[0	Text	Enter the specific detail required for Line 9a on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line9[0].Line9a[0].f6_78[0	Text	Enter the specific detail required for Line 9a on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line9[0].Line9a[0].f6_79[0	Text	Enter the specific detail required for Line 9a on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line9[0].Line9a[0].f6_82[0	Text	Enter the specific detail required for Line 9a on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line9[0].Line8b[0].f6_83[0	Text	Enter the specific detail required for Line 8b on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line9[0].Line8b[0].f6_84[0	Text	Enter the specific detail required for Line 8b on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line9[0].Line8b[0].f6_85[0	Text	Enter the specific detail required for Line 8b on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line9[0].Line8d[0].f6_97[0	Text	Enter the specific detail related to Line 8d on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line9[0].Line8d[0].AmountOfClaim[0].f6_98[0	Text	Enter the amount of claim for Line 8d on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line9[0].Line8d[0].AmountOfClaim[0].f6_99[0	Text	Enter the amount of claim for Line 8d on Page 6 of Form 720. This field has a maximum length of 3 characters. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line9[0].Line8d[0].f6_100[0	Text	Enter the specific detail related to Line 8d on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line9[0].Line8e[0].f6_101[0	Text	Enter the specific detail related to Line 8e on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line9[0].Line8e[0].f6_102[0	Text	Enter the specific detail related to Line 8e on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line9[0].Line8e[0].f6_103[0	Text	Enter the specific detail related to Line 8e on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line9[0].Line8e[0].AmountOfClaim[0].f6_104[0	Text	Enter the amount of claim for Line 8e on Page 6 of Form 720.
topmostSubform[0].Page6[0].Table_Line9[0].Line8e[0].AmountOfClaim[0].f6_105[0	Text	Enter the amount of claim for Line 8e on Page 6 of Form 720. This field has a maximum length of 3 characters. Max length: 3 characters
topmostSubform[0].Page6[0].Table_Line9[0].Line8e[0].f6_106[0	Text	Enter the specific detail related to Line 8e on Page 6 of Form 720.
topmostSubform[0].Page7[0].Table_Line12[0].Line12c[0].f7_13[0	Text	Enter the specific detail required for Line 12c, column f7_13 on Page 7.
topmostSubform[0].Page7[0].Table_Line12[0].Line12c[0].f7_14[0	Text	Enter the specific detail required for Line 12c, column f7_14 on Page 7.
topmostSubform[0].Page7[0].Table_Line12[0].Line12c[0].AmountOfClaim[0].f7_15[0	Text	Enter the amount of claim for Line 12c, column AmountOfClaim on Page 7.
topmostSubform[0].Page7[0].Table_Line12[0].Line12c[0].AmountOfClaim[0].f7_16[0	Text	Enter the amount of claim for Line 12c, column AmountOfClaim on Page 7. Maximum length is 3 characters. Max length: 3 characters
topmostSubform[0].Page7[0].Table_Line12[0].Line12c[0].f7_17[0	Text	Enter the specific detail required for Line 12c, column f7_17 on Page 7.
topmostSubform[0].Page7[0].Table_Line12[0].Line12d[0].f7_18[0	Text	Enter the specific detail required for Line 12d, column f7_18 on Page 7.
topmostSubform[0].Page7[0].Table_Line12[0].Line12d[0].f7_19[0	Text	Enter the specific detail required for Line 12d, column f7_19 on Page 7.
topmostSubform[0].Page7[0].Table_Line12[0].Line12d[0].AmountOfClaim[0].f7_20[0	Text	Enter the amount of claim for Line 12d, column AmountOfClaim on Page 7.
topmostSubform[0].Page7[0].Table_Line12[0].Line12d[0].AmountOfClaim[0].f7_21[0	Text	Enter the amount of claim for Line 12d, column AmountOfClaim on Page 7. Maximum length is 3 characters. Max length: 3 characters
topmostSubform[0].Page7[0].Table_Line12[0].Line12d[0].f7_22[0	Text	Enter the specific detail required for Line 12d, column f7_22 on Page 7.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13b[0].f7_33[0	Text	Enter the specific details for Line 13b on Page 7. This field is used to provide additional information related to the excise tax being reported.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13c[0].f7_34[0	Text	Enter the specific details for Line 13c on Page 7. This field is used to provide additional information related to the excise tax being reported.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13c[0].f7_35[0	Text	Enter the specific details for Line 13c on Page 7. This field is used to provide additional information related to the excise tax being reported.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13c[0].f7_38[0	Text	Enter the specific details for Line 13c on Page 7. This field is used to provide additional information related to the excise tax being reported.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13d[0].f7_39[0	Text	Enter the specific details for Line 13d on Page 7. This field is used to provide additional information related to the excise tax being reported.
topmostSubform[0].Page7[0].Table_Line13_2[0].Line13d[0].f7_40[0	Text	Enter the specific details for Line 13d on Page 7. This field is used to provide additional information related to the excise tax being reported.
Tax Information
Reserved item — Sales price (Part I)	Number	Enter the sales price for the reserved-for-future-use item used to calculate the 2.3% tax in Part I.
Reserved item — Tax (Part I)	Number	Enter the tax computed on the reserved-for-future-use sales price at the 2.3% rate. Max length: 3 characters
Part I total — primary amount	Number	Enter the total of all amounts from Part I (primary total field). Fill only if 'Gas guzzler tax — Check if one-time filing' is 'No'. Depends on: Gas guzzler tax — Check if one-time filing
Part I total — secondary amount	Number	Enter the total of all amounts from Part I (secondary total field). Fill only if 'Gas guzzler tax — Check if one-time filing' is 'No'. Max length: 3 characters Depends on: Gas guzzler tax — Check if one-time filing
Avg. number of lives covered — specified policies (policy year before Oct 1, 2023)	Number	Enter the average number of lives covered by specified health insurance policies with a policy year ending before October 1, 2023.
topmostSubform[0].Page2[0].PartIITable[0].BodyRow2[0].f2_64[0	Text	Enter the tax code or identifier for the second row in Part II of the form.
Fee — specified policies (policy year before Oct 1, 2023)	Number	Enter the fee amount calculated for specified health insurance policies with a policy year ending before October 1, 2023.
Avg. number of lives covered — specified policies (policy year on/after Oct 1, 2023)	Number	Enter the average number of lives covered by specified health insurance policies with a policy year ending on or after October 1, 2023 and before October 1, 2024.
topmostSubform[0].Page2[0].PartIITable[0].BodyRow3[0].f2_67[0	Text	Enter the tax code or identifier for the third row in Part II of the form.
Fee — specified policies (policy year on/after Oct 1, 2023)	Number	Enter the fee amount calculated for specified health insurance policies with a policy year ending on or after October 1, 2023 and before October 1, 2024.
topmostSubform[0].Page2[0].IRSno41-140Table[0].IRSno44[0].f2_88[0	Text	Enter the specific tax information for IRS number 44.
Tax — bows, quivers, broadheads and points	Number	Enter the tax due for bows, quivers, broadheads, and points (11% of sales price).
IRS reference — bows, quivers, broadheads and points	Text	Enter the IRS reference number or code associated with the bows/quivers/broadheads/points line. Max length: 3 characters
topmostSubform[0].Page2[0].IRSno41-140Table[0].IRSno106[0].f2_91[0	Text	Enter the specific tax information for IRS number 106.
Tax — arrow shafts	Number	Enter the tax due for arrow shafts at the indicated per-shaft rate.
IRS reference — arrow shafts	Text	Enter the IRS reference number or code associated with the arrow shafts line. Max length: 3 characters
topmostSubform[0].Page2[0].IRSno41-140Table[0].IRSNo140[0].f2_94[0	Text	Enter the specific tax information for IRS number 140.
Tax — indoor tanning services	Number	Enter the tax due for indoor tanning services at the applicable rate.
IRS reference — indoor tanning services	Text	Enter the IRS reference number or code associated with the indoor tanning services line. Max length: 3 characters
Number of gallons — LUST tax on inland waterways fuel use	Number	Enter the number of gallons subject to the LUST tax on inland waterways fuel use.
Tax — LUST tax on inland waterways fuel use	Number	Enter the tax due for LUST tax on inland waterways fuel use.
IRS reference — LUST tax on inland waterways fuel use	Text	Enter the IRS reference number or code associated with the LUST tax on inland waterways fuel use line. Max length: 3 characters
Number of gallons — biodiesel sold but not used as fuel	Number	Enter the number of gallons of biodiesel sold that was not used as fuel.
Rate — biodiesel sold but not used as fuel	Number	Enter the applicable rate for biodiesel sold but not used as fuel.
Tax — biodiesel sold but not used as fuel	Number	Enter the tax due for biodiesel sold but not used as fuel.
IRS reference — biodiesel sold but not used as fuel	Text	Enter the IRS reference number or code associated with the biodiesel sold but not used as fuel line. Max length: 3 characters
9	Text	Enter the type of excise tax being reported.
topmostSubform[0].Page3[0].f3_14[0	Text	Enter a specific code or identifier related to the type of excise tax, limited to 3 characters. Max length: 3 characters
topmostSubform[0].Page3[0].f3_15[0	Text	Enter the amount of excise tax owed.
topmostSubform[0].Page3[0].f3_16[0	Text	Enter a specific code or identifier related to the amount of excise tax, limited to 3 characters. Max length: 3 characters
topmostSubform[0].Page3[0].Line11_ReadOrder[0].c3_2[0]_1	CheckBox	Check this box if a specific condition related to the excise tax applies.
topmostSubform[0].Page3[0].Line11_ReadOrder[0].c3_2[1]_2	CheckBox	Check this box if another specific condition related to the excise tax applies.
topmostSubform[0].Page3[0].f3_17[0	Text	Enter the total amount of excise tax owed for the quarter.
topmostSubform[0].Page3[0].f3_18[0	Text	Enter a specific code or identifier related to the total amount of excise tax, limited to 3 characters. Max length: 3 characters
topmostSubform[0].Page4[0].Table_SchA-1a[0].FirstMonth[0].FirstThru15[0].f4_1[0	Text	Enter the amount for the first month, first through the 15th. This field is for reporting specific tax amounts for the given period.
Taxpayer Information
topmostSubform[0].Page3[0].f3_9[0	Text	Enter the detailed information about the taxpayer, such as name or business name.
topmostSubform[0].Page3[0].f3_10[0	Text	Enter a specific code or identifier related to the taxpayer, limited to 3 characters. Max length: 3 characters
topmostSubform[0].Page3[0].f3_11[0	Text	Enter additional detailed information about the taxpayer, such as address or contact details.
topmostSubform[0].Page3[0].f3_12[0	Text	Enter another specific code or identifier related to the taxpayer, limited to 3 characters. Max length: 3 characters
Registration number	Text	Enter the registration number assigned to your business for federal excise tax purposes.
Registration number	Text	Enter your registration number.
Registration number	Text	Enter the registration number associated with the taxpayer for Form 720.
Registration number	Text	Enter the registration number of the taxpayer.
Period of claim	Text	Enter the period for which the claim is being made.
Registration number	Text	Enter the registration number of the taxpayer.
Registration number	Text	Enter the registration number of the business or taxpayer filing the Form 720.
1 Enter your employer identification number (EIN). See instructions	Text	Enter your employer identification number (EIN). Refer to the instructions for more details. This field is limited to 10 characters. Max length: 10 characters
Enter your address	Text	Enter the complete address of the business or taxpayer, including street address or P.O. Box.
Enter your city or town, state or province, country, and ZIP or foreign postal code	Text	Enter the city or town, state or province, country, and ZIP or foreign postal code of the business or taxpayer.
Tires Tax
Number of tires — taxable (other than bias ply or super single)	Text	Enter the total number of taxable tires for this category (taxable tires other than bias ply or super single tires).
Tax amount — taxable tires (other than bias ply or super single)	Number	Enter the tax amount due for the tires reported on this line.
IRS line number — taxable tires (other than bias ply or super single)	Text	Enter the IRS line number associated with this entry (the form’s line number for this category). Max length: 3 characters
Number of tires — taxable bias ply or super single (not steering)	Text	Enter the total number of taxable bias ply or super single tires for this category (excluding super single tires designed for steering).
Tax amount — taxable bias ply or super single (not steering)	Number	Enter the tax amount due for the bias ply or super single tires reported on this line.
IRS line number — taxable bias ply or super single (not steering)	Text	Enter the IRS line number associated with this entry (the form’s line number for this category). Max length: 3 characters
Number of tires — taxable super single tires designed for steering	Text	Enter the total number of taxable super single tires that are specifically designed for steering.
Tax amount — taxable super single tires designed for steering	Number	Enter the tax amount due for the super single tires designed for steering reported on this line.
IRS line number — taxable super single tires designed for steering	Text	Enter the IRS line number associated with this entry (the form’s line number for this category). Max length: 3 characters
Two-Party Exchange
topmostSubform[0].Page4[0].TwoPartyExchangeTable[0].Row1[0].f4_33[0	Text	Enter the amount for the first row in the Two-Party Exchange Table.
topmostSubform[0].Page4[0].TwoPartyExchangeTable[0].Row2[0].f4_34[0	Text	Enter the amount for the second row in the Two-Party Exchange Table.
topmostSubform[0].Page4[0].TwoPartyExchangeTable[0].Row3[0].f4_35[0	Text	Enter the amount for the third row in the Two-Party Exchange Table.
topmostSubform[0].Page4[0].TwoPartyExchangeTable[0].Row4[0].f4_36[0	Text	Enter the amount for the fourth row in the Two-Party Exchange Table.
topmostSubform[0].Page4[0].TwoPartyExchangeTable[0].Row5[0].f4_37[0	Text	Enter the amount for the fifth row in the Two-Party Exchange Table.
topmostSubform[0].Page4[0].TwoPartyExchangeTable[0].Row6[0].f4_38[0	Text	Enter the amount for the sixth row in the Two-Party Exchange Table.
topmostSubform[0].Page4[0].TwoPartyExchangeTable[0].Row7[0].f4_39[0	Text	Enter the relevant information for the two-party exchange in Row 7.
topmostSubform[0].Page4[0].TwoPartyExchangeTable[0].Row8[0].f4_40[0	Text	Enter the relevant information for the two-party exchange in Row 8.

Form 720, Quarterly Federal Excise Tax Return Instructions