Form Sf# 49083 - Schedules 1a, 2a And 3a Transporter Schedule Of Deliveries 2007

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Schedules 1A, 2A and 3A
SF# 49083
(R3/05-07)
Transporter Schedule of Deliveries
License Holder
License Number
Month / Year
FEIN
You may photocopy this blank schedule for future fi lings. Attach additional sheets as necessary.
Schedule Type (Check One)
Product Code/Type (Check One)
For Use with Reporting Special Fuel
For Use with Reporting Gasoline/Oil Inspection
1A Exports
142
Kerosene
065
Gasoline
160
Diesel Fuel - clear
124
Gasohol
2A Imports
170
Biodiesel - undyed (blended product)
125
Aviation Fuel
3A In-State Transfers
171
Biodiesel - dyed (blended product)
130
Jet Fuel
228
Diesel Fuel - dyed
142
Kerosene
B00
Biodiesel (B-100) - undyed
150
#1 Fuel Oil - undyed
D00
Biodiesel (B-100) - dyed
161
Low Sulfur Diesel #1 - undyed
OTH
Other (specify)
231
No. 1 Diesel - dyed
167
Low Sulfur Diesel #2 - undyed
E00
Ethanol - (100%)
161
Low Sulfur Diesel #1 - undyed
E85
85% Ethanol / 15% Gasoline
M00
Methanol - (100%)
OTH
Other (specify)
Person Hiring
Seller Information
Delivered to
the Carrier
(Fuel Withdrawn From)
(13)
(14)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
Import
Billed or
Name
FEIN
Name
FEIN
Mode
State of
Name
FEIN
Destination
Document
Document
Gross
Verifi cation
Net
Origin
State
Date
Number
Gallons
Gallons
Number
Total

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