Form Pda-46q - Petroleum Division
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1MINNESOTA Department of Revenue
Petroleum Division
PDA-46Q
Check one (1) only
Gasoline sales to qualifying service stations
E-85 Fuel
Aviation gasoline
Sheet no.
For month of
19
.
Master jobber
Name
Address
City or town
State
Zip code
Sales detail
To whom sold
Mailing address
Town where delivered
Date
Ticket no. Gallons
Total gallons
1. Less 2.5% (.025) evaporation and loss allowance .......................................................................................1
2. Net gallons subject to rate reduction ..........................................................................................................2
3. Tax rate reduction per gallon ....................................................................................................................3
4. Tax adjustment (Line 2 x Line 3) ................................................................................................................4
(Credit to be taken on PDA-46, Line 16)
Rev.8/01
Printed on recycled paper with 10% post-consumer waste using soy-based ink.
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Parent category: Financial