§ 303.13. Form.

 Claims for reimbursement of the tax shall be made upon a form furnished by the Board and shall include the name and address of the claimant, the period of time and the number of gallons of liquid fuels used for which reimbursement is claimed, and a descriptive list of the automotive equipment of the political subdivision which consumed the fuel. The claim shall contain verification or certification that the liquid fuels for which reimbursement is claimed have been used only by the equipment of the political subdivision and that no part of such claim has been paid except as stated.

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