Form Pda-56 - Gasoline And Other Fuels Multiple Schedule - Minnesota Department Of Revenue
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1
2PDA-56
Gasoline and Other Fuels Multiple Schedule
Company name
Minnesota tax ID number
Address
City
State
Zip code
For month of
20
Check applicable line. See instructions on back.
Shipments received from Minnesota terminals and refineries on which tax was not paid (enter totals on line 1 of PDA-46)
Shipments imported to Minnesota from the state of
(enter totals on line 2 of PDA-46)
Shipments exported from Minnesota to the state of
(enter totals on line 4 of PDA-46)
A
B
C
D
E
F
G
H
Point of origin
Name of carrier
Unloaded at
Date
Manifest
Gallons
Gallons
Other
Terminal
Supplier
(name and location)
number
gasoline
undyed diesel fuel
TOTALS
(Rev. 12/02)
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