IFTA Fuel Tax Reporting Agreement
In contracting with LB Safety Operations Services, Inc. to prepare quarterly International Fuel Tax Agreement (IFTA) and state mileage reports, I testify that I understand the rules of IFTA which include, but are not limited to the rules set forth in IFTA Manual. A copy of this manual can be located at http://www.iftach.org.
It is explicitly understood that the undersigned is knowledgeable of the IFTA and state mileage record keeping requirements and agrees to prepare and maintain adequate documentation. It is further agreed, that any taxes assessments, penalties, and/or interest associated with IFTA and/or state mileage tax report filing or audit are not the responsibility of LB Safety Operations Services, Inc.. LB Safety Operations Services, Inc. certifies that it will make its best effort to provide accurate and timely reports.
LB Safety Operations Services, Inc. can only process information that has been provided to our company. LB Safety Operations Services, Inc. is not responsible for information that has not been provided. Failure to provide all information in a timely fashion could result in reports being prepared late and associated penalties and interest.
All data concerning International Fuel Tax Reports must be documented in sufficient detail. It is explicitly understood that you must have supporting information that includes the following:
By signing below, I acknowledge understanding the above provisions of this agreement.
Company Name:_____________________________________________
Street Address:___________________________ City:_______________
State:___________ Zip:__________ Phone:_______________________
Fax:____________________ Email:_____________________________
Applicants Name:____________________________________________
Date_____________________ Title:_____________________________
Signature__________________________________________________
Print, Complete and FAX 931-657-5668