Form 575 - Terminal Operator Report - Missouri Department Of Revenue - 2006 Page 2

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INSTRUCTIONS

FOR TERMINAL OPERATOR REPORT

LINE NUMBER:

1. Enter beginning inventory stored in the terminal for the first day of the month (ending inventory from previous month’s report).

2. Enter the total gallons of fuel received for the month (total from Terminal Receipts Schedule TR and 2X).

3. Total gallons available (add Lines 1 and 2).

4. Enter the total gallons of fuel disbursed for the month (total from Terminal Disbursement Schedule TD and 6X).

5. Gallons available (Line 3 minus Line 4).

6. Enter the stock loss and/or gain if applicable for the month. If the amount of the stock loss and/or gain exceeds one half of one percent of the number of net

gallons received, attach documentation to the report.

7. Actual ending inventory balance in the terminal (Line 5 adjusted by Line 6).

If you have questions or need assistance in completing this form, please call (573) 751-2611 or e-mail excise@dor.mo.gov. You may also access the

department’s web site at to obtain this form.