Form Rfm-10 - Combined Motor Fuel Tax Return - State Of New Jersey Division Of Revenue Page 7

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Division 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
RMF309
Taxpayer Name
Taxpayer ID Number
Line
Date
Seller
Document #
Gallons
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Total Gallons
X 5¼¢
Tax Rate
Total Tax Paid on Purchases
Multiply Total Gallons by 0.0525
Enter this amount on RMF-10, Line 9

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