Form 720-To Draft - Terminal Operator Report 2010 - Department Of The Treasury Page 4
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Form 720-TO (Rev. 9-2010)
Corrected
Void
Page
Terminal operator name as shown on Form 720-TO
EIN
TCN
For the month ending (enter MM/DD/YYYY)
Schedule B
Terminal Operator Disbursements by Position Holder
Page
of
Position Holder name. Enter one name per page.
PH EIN
PH Form 637 registration number
For more than one Schedule B, for each different PC, DS, or
MC, number each sheet. For example, 1 of 4, 2 of 4, etc.
Complete lines 1 through 4 for each PC.
1
Product Code (PC). Enter the PC (see instructions). A separate schedule is required for each PC
1
2
Destination State (DS). Enter the DS for each PC (see instructions). A separate schedule is required for each PC by state. PC 167 destined for Virginia
(VA) and Maryland (MD) requires two schedules
2
3
Mode Code (MC). Enter the MC (see instructions) for each PC for each DS. PC 167 destined for VA by truck and rail and destined for MD by truck and
rail would require four separate schedules: (1) PC 167, VA, rail; (2) PC 167, VA, truck; (3) PC 167, MD, rail; and (4) PC 167, MD, truck
3
Example. ABC Terminal is preparing Schedule B for disbursements made by position holder XYZ. XYZ disburses gasoline (PC 065), diesel fuel #2 low sulphur undyed
(PC 167), and jet fuel (PC 130) during the month destined for two states by truck. ABC must prepare six Schedules B to report XYZ’s transactions (3 PCs x 2 DSs). A
further breakdown by MC is not needed because only truck was used.
4
Enter in the columns below the information requested for the PC on line 1 above.
(c)
(d)
(e)
(f)
(g)
(a)
(b)
Vessel official number
Document
Document
Net
Gross
Carrier
Carrier
(required when mode code is
number
gallons
date
gallons
name
EIN
B, S, IB, IS, EB, or ES)
5
Totals. Add all amounts in columns (f) and (g) for each PC, DS, or MC. If there are two MCs for a product destined for one
state, or if a product is destined for two states, then two Schedules B and totals are required. If there is more than one Schedule
B for a PC, DS, or MC, add the amounts from each schedule and enter the result on the last page of Schedule B for each
different PC, DS, or MC. Do not enter page subtotals. Enter the amount from column (f) for each PC on Form 720-TO, Part III,
line 4, in the column for the applicable PC
5(f)
5(g)
720-TO
Form
(Rev. 9-2010)
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