Form Rfm-10 - Combined Motor Fuel Tax Return - State Of New Jersey Division Of Revenue Page 4
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11Division use only — DLN Stamp
Division use only — Date Stamp
Period
mm
yyyy
Attach to Form RMF-10
Pursuant to NJSA 54:39-101 et seq
01-2011
Use more than one Schedule if needed
Schedule of Tax Paid Purchases - Kerosene
RMF204
Taxpayer Name
Taxpayer ID Number
Line
Date
Seller
Document #
Gallons
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Total Gallons
X 13½¢
Tax Rate
Total Tax Paid on Purchases
Multiply Total Gallons by 0.135
Enter this amount on RMF-10, Line 4
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