4923-2026

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Click ‘Get Form’ to open the 4923 in the editor.
Begin by entering your personal information in the Claimant section, including your name, email address, and mailing address. Ensure all details are accurate for smooth processing.
In the Fuel Usage section, specify the total gallons of fuel used for various purposes as outlined in lines 1 through 15. Be sure to round totals to the nearest gallon.
Calculate the total tax paid on motor fuel gallons used for off-road purposes by multiplying the total gallons subject to a refund by the applicable tax rate.
Complete the banking information if you wish to receive your refund via direct deposit. Fill in your routing number and account number accurately.
Finally, sign and date the form at the bottom. Remember that unsigned claims will be returned.

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