1998 Sheet Of Gasoline Distributor'S Schedule Of Disbursements
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1Gasoline Distributor's Schedule of Disbursements
Company Name
Registration Number
FEIN
Schedule Type
Month/Year
Schedule Type
Product Type - (Circle One)
5. Gallons delivered to other distributors - tax collected
65 Gasoline
6. Gallons delivered to licensed distributors - tax not collected
124 Gasohol
7. Gallons exported to state of ___________________
125 Aviation Gasoline
8. Gallons delivered to U. S. Government - tax exempt
130 Jet Fuel
9. Gallons delivered to political subdivisions of this State
___ Other (see FTA product code list)
10. Gallons of jet fuel delivered for international flights
22. Dealer credit card sales to U.S. Government and dealer sales supported by 1094's
(1)
(2)
(3)
( 4 )
(5)
(6)
(7)
(8)
(9)
(10)
Carrier
Carrier
Point of
Sold
Purchaser's
Date
Document
Net
Gross
Name
FEIN
Mode
Origin
Dest.
to
FEIN
Shipped
Number
Gallons
Gallons
Total
GASDURS
Revised July 1, 1998
Reproduce as needed
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Parent category: Financial