Form Gas-1262 - Motor Fuels Application - North Carolina Department Of Revenue - 2008 Page 13
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2364. What other types of operations will you be engaged in?
Exchanges
Direct shipments
Other - Describe
Sales on consignment
Sell petroleum products
Trade petroleum products
Operate service stations
65. Provide the following information about suppliers from whom you purchase motor fuel and exchange partners from whom you receive
motor fuel. (Attach additional sheets if necessary.)
Name
Shipping/Delivery Point
Product
Exporter License
List Federal 637 Number (If applicable):
Yes
No
66. Do you maintain bulk storage facilities in North Carolina?
67. Where will your bulk storage be located?
68. Fuel Storage Capacity:
Above Ground
Below Ground
69. If no bulk storage facility is owned, explain storage arrangements.
Yes
No
70. Do you plan to export petroleum products out of North Carolina?
71. Indicate the type of petroleum products exported from this state.
Gasoline
Undyed Kerosene
Aviation Gasoline
Alcohol
Low Sulfur Diesel
Dyed Kerosene
Ethanol
Propane
High Sulfur Diesel
Jet Fuel
Methanol
Undyed Biodiesel
72. Indicate the means of transport for this exported product.
Dyed Biodiesel
Transport Truck
Seagoing Vessel/Barge
Tank Wagon
Pipeline
Railroad Tank Car
Other - Describe
73. List the destination states for exported petroleum products and your license number in those states. (Attach additional sheets if necessary.)
74. Estimate the number of taxable gallons that will be exported from this state during an average month.
Dyed
Gasoline
Methanol
Kerosene
Low Sulfur
Jet Fuel
Alcohol
Diesel
High Sulfur
Aviation
Propane
Diesel
Gasoline
Undyed
Undyed
Ethanol
Biodiesel
Kerosene
Dyed
Biodiesel
Yes
No
75. Are you a shipper of record on one of the commercial pipelines serving North Carolina?
Blender License
List Federal 637 Number:
Yes
No
76. Do you intend to blend taxed motor fuel with an untaxed blending component?
77. If yes, what are you blending with gasoline or diesel?
No
78. Do you plan to purchase gasoline blending stocks such as natural gas?
Yes
Yes
No
79. Do you plan to purchase transmix?
Yes
No
80. Do you plan to blend gasoline and alcohol or methanol?
81. Where will the blending be done?
82. Describe blending operation.
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