Form Gas-1264ds - Fuel Alcohol And Biodiesel Provider Schedule Of Disbursements - 2004
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1Fuel Alcohol and Biodiesel Provider Schedule of Disbursements
GAS-1264DS
Web
North Carolina Department of Revenue
File with GAS-1264
1-04
Schedule
Product
Legal Name (First 30 Characters) (USE CAPITAL LETTERS FOR YOUR NAME)
Account Number
Type
Type
Month
Year
-
Schedule Type
Mode (Column 3)
Product Type
Gallons sold to retailers, bulk-end users, unlicensed distributors, and company-owned stations
5A
J
=
Truck
123 Alcohol
5C
Gallons sold to licensed suppliers and distributors
R
=
Rail
241 Ethanol
Gallons sold to bonded importers, occasional importers, or tankwagon importers
5E
243 Methanol
B
=
Barge
Gallons sold to licensed distributors and licensed importers for exempt purposes
6D
284 Biodiesel - Undyed
PL
=
Pipeline
Dyed biodiesel gallons sold for non-taxable purposes
6F
290 Biodiesel - Dyed
S
=
Ship
7A
Gallons sold for export - taxes collected from destination state of ____________
BA =
Book Adjustment
7E
Exempt gallons sold for export
ST =
Stationary Transfer
Gallons sold to the U.S. Government
8
CE =
Summary
Gallons sold to the State of North Carolina
9A
9C
Gallons sold to a N.C. local board of education
9E
Gallons sold to a N.C. county or municipal corporation
Gallons sold to a N.C. charter school
9F
Gallons sold to a N.C. community college
9G
(5)
(1)
(2)
(3)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(4)
Terminal
Carrier
Carrier
Purchaser
Purchaser
Date
Document
Net
Gross
Billed
Mode
Control
Name
FEIN
Name
FEIN
Shipped
Number
Gallons
Gallons
Gallons
Origin Dest.
Number
TOTAL
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