Instructions For Forms 720-To And 720-Cs - (March 2001) Page 12
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16Example 9. Non-bulk, summary by PH
Terminal operator name as shown on Form 720-TO
EIN
TCN
For the month ending (enter MM/DD/YYYY)
ABC Terminal Inc.
10 1234567
T59FL1111
04/30/2001
Schedule B
Terminal Operator Disbursements by Position Holder
Position holder (PH) name. Enter one name per page.
PH EIN
PH Form 637 Registration Number
Chemical Inc.
10-8888888
10-95-3333S
Product code.
Enter in the columns below the information requested for the specified product code. Use additional schedule(s) for each product code.
092
See page 5 in the instructions for product codes.
(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)
Carrier
Carrier
Mode of
Dest.
Document
Document
Net
Gross
name
EIN
trans.
state
date
number
gallons
gallons
Various
99-9999999
CE
FL
04302001
Summary
4000
4000
Total. Add amounts in columns (g) and (h) and enter the totals. Also, enter the amount from column (g) on Form 720-TO, line 4, in
4000
4000
the column for the applicable product code
Example 10. Non-bulk, summary by PH
Terminal operator name as shown on Form 720-TO
EIN
TCN
For the month ending (enter MM/DD/YYYY)
ABC Terminal Inc.
10 1234567
T59FL1111
04/30/2001
Schedule B
Terminal Operator Disbursements by Position Holder
Position holder (PH) name. Enter one name per page.
PH EIN
PH Form 637 Registration Number
Energy Company
10-5555555
10-95-4444S
Product code.
Enter in the columns below the information requested for the specified product code. Use additional schedule(s) for each product code.
092
See page 5 in the instructions for product codes.
(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)
Carrier
Carrier
Mode of
Dest.
Document
Document
Net
Gross
name
EIN
trans.
state
date
number
gallons
gallons
Various
99-9999999
CE
FL
04302001
Summary
2500
2500
Total. Add amounts in columns (g) and (h) and enter the totals. Also, enter the amount from column (g) on Form 720-TO, line 4, in
2500
2500
the column for the applicable product code
Example 11. Non-bulk, detail transaction
Terminal operator name as shown on Form 720-TO
EIN
TCN
For the month ending (enter MM/DD/YYYY)
ABC Terminal Inc.
10 1234567
T59FL1111
04/30/2001
Schedule B
Terminal Operator Disbursements by Position Holder
Position holder (PH) name. Enter one name per page.
PH EIN
PH Form 637 Registration Number
Fuel Company
10-1111222
10-95-1111S
Product code.
Enter in the columns below the information requested for the specified product code. Use additional schedule(s) for each product code.
065
See page 5 in the instructions for product codes.
(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)
Carrier
Carrier
Mode of
Dest.
Document
Document
Net
Gross
name
EIN
trans.
state
date
number
gallons
gallons
Tyler Trucking
10-3333333
J
GA
04052001
21
8210
7900
Total. Add amounts in columns (g) and (h) and enter the totals. Also, enter the amount from column (g) on Form 720-TO, line 4, in
8210
7900
the column for the applicable product code
Page 12
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