Form Wv/mft-508b - Importer Schedule Of Tax-Unpaid Receipts

INSTRUCTIONS

This schedule provides detail in support of the tax-unpaid receipts amount(s) shown on your monthly West Virginia Importer Report (WV/GAS-508). Upon

prior approval, you may submit a schedule summarizing your tax-unpaid receipts schedules, which must be formatted the same as the West Virginia

Importer Schedule of Tax-Unpaid Receipts (WV/GAS-508B). If you choose to submit summary schedules, you must still submit the schedules of individual

tax-unpaid receipts.

Complete Separate Schedules for Each Product Type and Point Of Origin. Group Sellers Together.

FEIN/SSN

Enter the Federal Employment Identification Number (FEIN) or

Social Security Number (SSN) as shown on your monthly West Virginia Importer Report.

Name

Enter the Name of the Company as shown on your monthly West Virginia Importer Report.

Report Month/Year

Enter the Month and Year you are reporting.

Product Information

Check the applicable box for the product type accounted for on this schedule.

Motor Fuel Transporter’s Name

Enter the Name of the Company that transported the product.

Motor Fuel Transporter’s FEIN/SSN

Enter the FEIN or SSN of the company that transported the product.

Mode

Enter the code for the mode of transport used to move the product (see Mode of Transportation Codes on the front).

Point of Origin

Enter the IRS Terminal Control Number if the product was received from a terminal.

Otherwise, enter the City and State where the shipment originated.

Point of Destination

Enter the City and State where the product was delivered.

Seller’s Name

Enter the Name of the Company that sold the product to you.

Seller’s FEIN/SSN

Enter the FEIN or SSN of the company that sold the product to you.

Date Received

Enter the date (Month, Day, Year) the product was received.

Document Number

Enter the Terminal Manifest Number or Bulk Plant Withdrawal Invoice Number.

Gross Gallons

Enter the Gross Gallons you delivered.

Net Gallons

Enter the Net Gallons you delivered.

Invoiced Gallons

Enter the total number of Gallons Invoiced.

Import Confirmation Number

Enter the Confirmation Number you received from the West Virginia State Tax Department when the product was imported into West Virginia

Form Wv/mft-508b - Importer Schedule Of Tax-Unpaid Receipts - 2003 Page 2