Form Gas-1202ds - Motor Fuel Supplier Schedule Of Disbursements - 2004

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Motor Fuel Supplier Schedule of Disbursements
File with GAS-1202
Gas-1202DS
North Carolina Department of Revenue
Web
1-04
Schedule
Product
Legal Name (First 35 Characters) (USE CAPITAL LETTERS FOR YOUR NAME)
Account Number
Month
Year
Type
Type
-
Schedule Type
5A
Gallons sold to retailers, bulk-end users, unlicensed distributors, and company-owned stations
5C
Gallons sold to licensed suppliers and distributors
Mode (Column 3)
Product Type
5E
Gallons sold to bonded importers, occasional importers, or tankwagon importers
5F
Dyed diesel and dyed kerosene gallons sold for taxable purposes
=
J
Truck
065 Gasoline
142 Kerosene - Undyed
6D
Gallons sold to licensed distributors and licensed importers for exempt purposes
=
R
Rail
072 Kerosene - Dyed
160 Diesel - Undyed
6F
Dyed diesel and dyed kerosene gallons sold for non-taxable purposes
=
B
Barge
122 Blending Components
226 Diesel - High Sulfur Dyed
6X
Gallons exchanged between licensed suppliers
=
PL
Pipeline
123 Alcohol
227 Diesel - Low Sulfur Dyed
7A
Gallons sold for export - taxes collected from destination state of ____________
S
=
Ship
124 Gasohol
241 Ethanol
7E
Exempt gallons sold for export
BA
=
Book Adjustment
125 Aviation Gasoline
243 Methanol
8
Gallons sold to the U.S. Government
ST
=
Stationary Transfer
130 Jet Fuel
284 Biodiesel - Undyed
9A
Gallons sold to the State of North Carolina
CE
=
Summary
290 Biodiesel - Dyed
9C
Gallons sold to a N.C. local board of education
9E
Gallons sold to a N.C. county or municipal corporation
9F
Gallons sold to a N.C. charter school
9G
Gallons sold to a N.C. community college
(5)
(4)
(1)
(2)
(3)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
Terminal
Carrier
Carrier
Purchaser
Purchaser
Date
Document
Net
Gross
Billed
Mode
Control
Name
FEIN
Name
FEIN
Shipped
Number
Gallons
Gallons
Gallons
Origin
Dest.
Number
TOTAL

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