Gasoline Distributor'S Schedule Of Receipts Form - 1998
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1Gasoline Distributor's Schedule of Receipts
Company Name
Registration Number
FEIN
Schedule Type
Month/Year
Schedule Type
Product Type - (Circle One)
1 Gallons received tax paid
65 Gasoline
130 Jet Fuel
2 Gallons received from wholesalers or other licensed distributors
124 Gasohol
___ Other (see FTA product code list)
3 Gallons imported from another state direct to customer
125 Aviation Gasoline
4 Gallons imported from another state into tax free storage
(1)
(2)
(3)
( 4 )
(5)
(6)
(7)
(8)
(9)
(10)
Carrier
Carrier
Point of
Acquired
Seller's
Date
Document
Net
Gross
Name
FEIN
Mode
Origin
Dest.
From
FEIN
Rec'd
Number
Gallons
Gallons
Total
GASRECP
Revised July 1, 1998
Reproduce as needed
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Parent category: Financial