Form Scc-06 - Spill Compensation And Control Tax Public Storage Terminal Information Tax Return

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SCC-6
STATE OF NEW JERSEY
5-97, R-3
DIVISION OF TAXATION
SPILL COMPENSATION AND CONTROL TAX
PUBLIC STORAGE TERMINAL INFORMATION TAX RETURN
THIS RETURN MUST BE FILED BY THE 20TH DAY OF THE MONTH FOLLOWING THE CLOSE OF THE TAXABLE PERIOD
For The Taxable Period: (See instructions)
From: __________________________________ To: __________________________________
Name of Public Storage Terminal ___________________________________________ Fed. I.D. No._________________________________
Address ____________________________________ City__________________________ State _________ Zip Code___________________
(A)
(B)
Names and Addresses of
Petroleum and Petroleum Products
Other Hazardous Substances
Total
Total of
Total
Owners of Hazardous
(A)
Date
of
Liquid
Liquid
Other Petroleum Products
of
Non-Liquid
Substances Transferred
of
and
(A)
Barrels
Barrels
Non-Liquid
Liquid
Liquid
Converted to
(B)
to Your Terminal
Transfer
#2 Fuel
Converted to
(B)
Gasoline
Barrels
Barrels
Barrels
Barrels
Oil
(See Inst.)
(See Inst.)
TOTAL BARRELS OF HAZARDOUS SUBSTANCES TRANSFERRED TO YOUR TERMINAL . . . . . . . . . . . . . . . . . . . . . . . . .
Under penalty of perjury, I declare that this is a true, complete and correct return.
Send Return to:
_________________________________________________________________________________
State of New Jersey, SCC
SIGNATURE
PO Box 265
__________________________________________________
___________________________
Trenton, New Jersey 08646-0265
TITLE
DATE
READ INSTRUCTIONS CAREFULLY BEFORE COMPLETING RETURN

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