Instructions For Forms 720-To And 720-Cs - (March 2001) Page 8
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16Example 1
720-TO
Terminal Operator Report
OMB No. 1545-1734
Form
(March 2001)
Department of the Treasury
Corrected
Void
April
01
For the month ending
, 20
.
Internal Revenue Service
Part I
Terminal Operator
Company name
Employer Identification Number (EIN)
ABC Terminal Inc.
10 1234567
Address (number, street, room or suite number)
Form 637 Registration Number
17 Hickory Street
10-95-7777S
City, state, and ZIP code
Anytown, Texas 44444
Contact person
Daytime telephone number
Fax number
E-mail address
Tim Terminal
(
555 999-3333
)
(
555 999-2222
)
Part II
Terminal
Name of terminal
Terminal Control Number (TCN)
ABC Terminal, Seaport
T59FL1111
Terminal location
Seaport, Florida
Part III
Transactions for the Month
Net Gallons (attach additional schedule(s) if needed)
Enter the transactions for the period on Schedules A and B, then complete lines
1 through 7 for each product code (PC). See page 5 in the instructions for the
product codes.
(a)
(b)
(c)
(d)
065
167
227
092
PC:
PC:
PC:
PC:
1
Beginning inventory.
3381000
1983000
36000
Total receipts. Enter amounts from
2
Schedule A.
420000
360000
8000
16000
Total gallons available. Add lines 1
3
and 2.
3801000
2343000
8000
52000
Total disbursements. Enter amounts
4
from Schedule B.
783210
198929
8000
6500
5
Subtract line 4 from line 3.
3017790
2144071
45500
Stock gains and losses. Show
6
losses in (parentheses).
<990>
288
Actual physical ending inventory at
7
terminal.
3016800
2144359
45500
Under penalties of perjury, I declare that I have examined this return and accompanying schedules, and, to the best of my knowledge and belief, they are true, correct,
and complete.
Tim Terminal
President
May 31, 2001
Signature
Title, if applicable
Date
(Please type or print your name below signature.)
720-TO
For Paperwork Reduction Act Notice, see the separate instructions.
Cat No. 73072W
Form
(March 2001)
Page 8
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