Form Dmf -10 - Distributor Of Motor Fuels Tax Return Page 34
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44Division use only — DLN Stamp
Division use only — Date Stamp
Period
Attatch this Schedule to:
mm
yyyy
Form DMF-10, Distributor's Return
Pursuant to NJSA 54:39-101 et seq
10-2010
Schedule of AvFuels Purchased — Airport Safety Tax Included
DMF402
Organize data by Seller ID#and include a summary of gallons per Seller. Use additional DMF402's if needed.
Licensee
Licensee #
Product
Date Seller ID#
Seller
Carrier ID #
Carrier
Gallons
Code
Document #
Destination
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Total gallons this page
Total Gallons for DMF402
page
of
Report this amount on
DMF-10, Line 2, Column D
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