Form Gas-1262 - Motor Fuels Application - North Carolina Department Of Revenue - 2008 Page 18
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23Kerosene Supplier License
List Federal 637 Number (If applicable):
156. Do you maintain bulk storage facilities in North Carolina?
Yes
No
157. Where is your bulk storage located?
Above Ground
158. Fuel Storage Capacity:
Below Ground
159. If no bulk storage facility is owned, explain storage arrangements.
Yes
No
160. Do you plan to import petroleum products into North Carolina?
161. Indicate the type of petroleum products imported into North Carolina.
Undyed Kerosene
Dyed Kerosene
Jet Fuel
Aviation Gasoline
162. Indicate the means of transport for this imported product.
Transport Truck
Seagoing Vessel/Barge
Tank Wagon
Pipeline
Railroad Tank Car
Other - Describe
163. List the states from which you import petroleum products and your license number in those states. (Attach additional sheets if necessary.)
164. Estimate the number of taxable gallons that will be sold or used in North Carolina during an average month.
Undyed
Aviation
Jet Fuel
Kerosene
Gasoline
Dyed
Kerosene
Yes
No
165. Do you plan to export petroleum products out of North Carolina?
166. Indicate the type of petroleum products exported from North Carolina.
Undyed Kerosene
Dyed Kerosene
Jet Fuel
Aviation Gasoline
167. Indicate the means of transport for this exported product.
Seagoing Vessel/Barge
Transport Truck
Tank Wagon
Railroad Tank Car
Pipeline
Other - Describe
168. List the destination states for exported petroleum products and your license number in those states. (Attach additional sheets if
necessary.)
Yes
No
169. Are you a shipper of record on one of the commercial pipelines serving North Carolina?
170. 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
Dyed Diesel Distributor
171. Do you maintain bulk storage facilities in North Carolina?
Yes
No
172. Where is your bulk storage located?
Above Ground
173. Fuel Storage Capacity:
Below Ground
174. If no bulk storage facility is owned, explain storage arrangements.
Yes
No
175. Do you plan to import dyed diesel into North Carolina?
176. Indicate the type of dyed diesel imported into North Carolina.
Dyed Diesel
Dyed Biodiesel
177. Indicate the means of transport for this imported product.
Transport Truck
Seagoing Vessel/Barge
Tank Wagon
Pipeline
Railroad Tank Car
Other - Describe
Page 17
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