Schedule Mf-3b - Gasohol Distribution Schedule - State Of Connecticut Department Of Revenue Services

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SCHEDULE MF-3B
STATE OF CONNECTICUT
DEPARTMENT OF REVENUE SERVICES
GASOHOL DISTRIBUTION SCHEDULE
(REV. 03/00)
Month of
The purpose of this schedule is to provide specific
Use this schedule to prepare
Schedules 10, 11, 12, 13, 16A, and
information on your sales of gasohol.
22 for Form O-MF3.
Name of Licensed Distributor
Schedule Number
Prepare a separate schedule for
each schedule required.*
Connecticut Tax Registration Number
Title of Schedule
Insert schedule number and title
in the spaces provided.
Point of
Whole Gallons
(Round off to the
Date
Sold To
Method of Delivery
Shipment
Delivery
nearest gallon)
(1)
(2)
(3)
(4)
(5)
(6)
TOTAL GALLONS
(Transfer this total to appropriate line of Form O-MF3, Gasohol Tax Return)
*Schedule 10 must be submitted in duplicate. Prepare a separate set for each state.

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