STATE OF NEW MEXICO - TAXATION AND REVENUE DEPARTMENT
RPD - 44181
REV. 05/97
FUELS TAX UNIT
WHOLESALERS SCHEDULE OF PURCHASES
Taxpayer Identification Number
Month
Year
SCHEDULE TYPE
Company Name
o
Schedule A, Gallons Purchased from Within State
Address
Business
Document
NM Tax
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Tax Excluded
Tax Included
Date
Identification Number
Name
Number
Point
Sales
Sales
TOTALS