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Free Michigan 3778 Template in PDF

The Michigan Department of Treasury 3778 form is a mandatory document used for reporting and paying taxes on imported or diverted motor fuel within three business days. This form is essential for individuals and companies who import fuel from outside the United States or divert fuel intended for export back into Michigan. Completing the Michigan 3778 accurately helps ensure compliance with state tax regulations and avoids penalties.

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Structure

The Michigan 3778 form, also known as the Three Day Payment Voucher, plays a crucial role in the state's tax collection process for imported and diverted motor fuels. This form is mandatory for individuals and businesses importing fuel from outside the United States or diverting fuel originally intended for export to a destination within Michigan. Timeliness is essential; taxes must be reported and paid within three business days of the relevant event to avoid penalties. The form requires detailed information, including the company name, account number, contact details, and specific data about the fuel being imported or diverted, such as product names, codes, and gallons. Tax rates vary by fuel type, with gasoline products generally taxed at $0.19 per gallon, undyed diesel at $0.15, and aviation fuel at $0.03. Additionally, the form provides space for calculating total tax due, penalties for late filing, and interest, ensuring that all financial obligations are clearly outlined. Accurate completion of the Michigan 3778 form is vital, as it includes declarations under penalty of perjury, emphasizing the importance of honesty and accuracy in reporting. Understanding the requirements and instructions laid out in this form can help businesses navigate the complexities of fuel taxation in Michigan.

Form Example

Michigan Department of Treasury
3778 (Rev. 09-12)	Reason for 3-day Payment (see General Information on Page 2)

Three Day Payment Voucher		Import from outside the United States
Issued under authority of P.A. 403 of 2000, as amended. Filing is mandatory.		Diversion requiring 3-day payment
		Diversion requiring 3-day payment

Company Name	Account Number (FEIN or TR)

DBA

Contact Person Name

Address (Street, RR#, P.O. Box)

Telephone Number

Fax Number

City, State, ZIP

E-mail Address

IMPORT/DIVERSION INFORMATION

Date Import Entered Michigan

Document Number

Import Verification/Diversion Number

Date Verification Number Assigned

Enter Product Name, Codes and Gallons. See page 2 for instructions, product classification and codes.

Gasoline Products	Product Codes	Gallons	Tax Rate	Calculated Tax Due

1.	Gasoline	065	x .19	1.
2.	Product Name		x .19	2.
Ethanol	Products E70 - E99			3.
3.	Product Name	E____	x .19	3.
Undyed Diesel Products (see instructions on page 2)
4.	Undyed Diesel	160	x .15	4.
5.	Product Name		x .15	5.
5.	Product Name			5.
Undyed	Biodiesel Products B05 - B00
6.	Product Name	B____	x .15	6.
6.	Product Name			6.
Dyed Diesel Products (dyed to U.S. Standards)
7.	Dyed Diesel	228	x .00	7.
Dyed	Biodiesel
8.	Product Name	D____	x .00	8.
Aviation Products
9.	Aviation Fuel	125	x .03	9.
10.	Jet Fuel	130	x .03	10.
Miscellaneous
11.	Product Name		x ____	11.
Tax Calculation
12. Total Tax Due. Add lines 1 through 11			12.

13. Penalty for late filing (100%). Enter amount from line 12			13.

14. Interest. (1% above prime rate set January 1 and July 1 of each year)			14.
15. TOTAL REMITTANCE. Add lines 12, 13 and 14			15.

Under penalty of perjury, I declare that I have examined this voucher, and to the best of my knowledge and belief, it is correct and complete.

Authorized Signature		Signature of Preparer
I authorize Treasury to discuss my return and attachments with my preparer.			Do not discuss my return with my preparer.

Printed Name		Printed Name			Preparer FEIN

Title		Address

Telephone Number	Date	Telephone Number		Date

Questions ???? - Please call (517) 636-4600. Make check payable to "State of Michigan-Special Taxes." Print your account number on the front of your check. MAIL WITH REMITTANCE TO: Michigan Department of Treasury, Special Taxes Division, P.O. Box 30474, Lansing, MI 48909-7974.

3778, Page 2

Instructions for Form 3778, Three Day Payment Voucher

General Information - Tax is due on imported or diverted motor fuel within 3 business days after either of the following events:

•Imports from outside the United States by persons other than licensed Bonded Importers or Suppliers, when tax is not paid to supply source. An import verification number must be obtained prior to import.

•Diversions on all fuel intended for export from Michigan but diverted to a destination within Michigan. A diversion number must be obtained prior to the diversion. Attach a copy of Form 3750, SCHEDULE OF DIVERSION (11B) and/or a shipping document.

•Diversions by unlicensed importers on all fuel acquired outside Michigan, not intended for a Michigan destination, but diverted to Michigan. A diversion number must be obtained prior to the diversion. Attach a copy of Form 3750, SCHEDULE OF DIVERSION (11A) and/or a shipping document.

Payments not postmarked within three business days of the event are subject to 100% penalty, plus interest.

TO OBTAINAPPROPRIATEAUTHORIZATION CALL:

Import Verification Number 1-888-213-0676

To obtain a Diversion Number, log on to www.trac3.net. If you do not have access to the Internet, contact Motor Fuel at (517) 636-4600.

Instructions

Occasional Importers must include all products and payments reported on this Three Day Payment Voucher, and also on their quarterly Fuel Importer Return.

Provide all requested information: company name, complete address, federal employer identification number, contact person and telephone number, Date Import Entered Michigan, Document Number (bill of lading, manifest), Import Verification/Diversion Number, Date Authorization Number Assigned (either Import Verification Number or Diversion Number).

Report gallons being imported or diverted on the appropriate line of the Voucher (page 1, lines 1 through 11).

If the product being imported or diverted is not pre-identified, enter the product name and code in the space provided (see product code list below).

Diesel fuel dyed to Canadian standards must be reported as undyed diesel and applicable taxes must be paid.

Line 11, Miscellaneous: Enter name and product code (if applicable) of the miscellaneous product.

(a)If additional space is needed for a product, use line 11 to identify the fuel type. Multiply the gallons on line 11 by the appropriate tax rate.

(b)All other unidentified products: enter the name of the product, product code 092, the number of gallons and 0.19 in the tax rate column. Multiply the gallons by 0.19.

Fuel type categories and product codes: The tax rates and most common product and product code are listed below. See our Web site at www.michigan.gov/treasury for additional products and product codes.

Fuel Types and Product Codes				Tax Rate
				(per gallon)

Gasoline Products E01 - E69, E00 (denatured) (1% - 69%, and 100%) including:
065	- Gasoline	199 - Toluene		$.19
100	- Transmix	092 - Undefined Other Product
126	- Napthas
Ethanol Products E70 - E99 (70% - 99%):
E plus percentage (limit 2 digits)				$.19
Undyed Biodiesel B05 - B00 (5% - 100%):
B plus percentage (limit 2 digits)				$.15

Dyed Biodiesel D01 - D00 (1% - 100%)
D plus percentage (limit 2 digits)				$.00

Undyed Diesel Products (including diesel dyed to Canadian standards) including:
160	- Undyed Diesel	142 - Undyed Kerosene	281 - Mineral Oils	$.15
B01 - B04 Biodiesel Blend (1% - 4%)			(including mineral spirits)

Dyed Diesel Products (diesel dyed to US standards) including:				$.00
228 - Dyed Diesel		072 - Dyed Kerosene
Aviation Products including:				$.03
125 - Aviation Gasoline		130 - Jet Fuel

▼ Michigan 3778 PDF Form

Document Specs

Fact Name	Description
Purpose	The Michigan 3778 form is a Three Day Payment Voucher for taxes on imported or diverted motor fuel.
Governing Law	This form is issued under the authority of Public Act 403 of 2000, as amended.
Filing Requirement	Filing the Michigan 3778 form is mandatory for applicable transactions.
Payment Deadline	Payments must be postmarked within three business days of the import or diversion event.
Penalties	Late payments incur a 100% penalty, along with interest calculated at 1% above the prime rate.
Contact Information	For questions, individuals can call the Michigan Department of Treasury at (517) 636-4600.

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