Georgia Department Of Revenue Motor Fuel Tax Unit

Motor Fuel Tax Evasion Reporting Form


In order for the GaDOR to properly respond to potential motor fuel tax evasion schemes it is important that the informant provide detailed information about the alleged scheme so that GaDOR field agents/tax auditors can review the information and conduct such investigations as deemed necessary. All informant information received will be kept in the strictest of confidence and comply with GaDOR’s disclosure requirements regarding such information received. Please mark the envelope “CONFIDENTIAL” and send to the following name and address:

 
Georgia Department of Revenue
Motor Fuel Tax Unit, Suite 3100
1800 Century Blvd., N.E.
Atlanta, GA 30345-3205
(404) 417-4300
(404) 417-4303 (Fax)
Toll Free Hotline (877) 383-5829
(877) FUEL TAX
e-mail: ronald.johnsonjr@dor.ga.gov


1. Under Market Sales Pricing: Please provide as much information as possible, to include:
 
  • Name and address of the service station
  •  
  • Name of the owner(s)
  •  
  • Name and address of motor fuel supplier(s)
  •  
  • Approximate number of gallons sold per month (supply pump totalizer readings if available)
  •  
  • Sales tax identification number of the retail station
  •  
  • Retail selling price of all grades of gasoline at that location
  •  
  • How long the service station has been in operation by the current owners/operators, any recent change in ownership, and period of time that below market prices were in effect
  •  
  • Names and addresses of retail service stations in the immediate area of the service station in question and their retail selling prices
  • If the scheme involves the diversion of motor fuels destined for out of state deliveries, you should include the names, addresses, phone numbers of those individuals and/or companies involved. Additional information might include distributor license numbers, vehicle license numbers, bill of lading numbers, terminal name and location, diversion date and location the load was diverted to as well as the common/private carrier name and address.


    2. Dyed Diesel Fuel Use on the Road. If the alleged motor fuel tax evasion scheme involves the use of red dyed diesel fuel (non-taxable) for on-highway purposes in licensed motor vehicles please include the following information:
     
  • Name and address of the individual and/or company
  •  
  • Location of the bulk tank where the red dyed fuel is stored
  •  
  • Number of on-highway vehicles in the fleet including license plate numbers (if available) and the yard location where the vehicles are kept at night and the name and address of the red dyed diesel fuel bulk supplier if known.

  • You must have an internet email service working in your browser and
    you must have a javascript enabled browser in order to email this information to the GaDOR.
    You must have javascript turned on in your browser.

    Enter all of the above requested information in the form fields below.

    If you find you are unable to use this form or are unwilling to submit the information via email, go here for a form which you can fill out and print on line and then mail to the address listed above.

    Enter the VIOLATION. Under Market Sales Pricing, Non-taxed Dyed Diesel Fuel Used on the Road, or Both.

    Enter your information:



    Your name(optional)

    Your phone number (optional)

    Date


    Back to the Motor Fuel Unit Homepage