Form 720-Cs Draft - Carrier Summary Report Page 3

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Form 720-CS (Rev. 9-2010)
Page
Corrected
Void
Carrier name as shown on Form 720-CS
EIN
Form 637 registration number
For the month ending (enter MM/DD/YYYY)
Schedule A
Carrier Receipts
Facility name. Complete a separate Schedule A for each facility.
FCN of facility
Page
of
1 Product Code (PC).
Enter the PC (see instructions). A separate schedule is
For more than one Schedule A, for each different PC, number each sheet. For
required for each PC
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example, 1 of 4, 2 of 4, etc.
2
Enter in the columns below the information requested for the PC on line 1 above.
(d)
(a)
(b)
(c)
(e)
(f)
(g)
Vessel official number
Consignor
Consignor
Mode
Document
Document
Net
(required when mode
EIN
name
code
date
number
gallons
code is B, S, IB, IS, EB, or ES)
3 Total.
Add all amounts in column (g) and enter the total. If there is more than one page for a PC, add the amounts from each page and enter the result on the
last page of Schedule A for that PC. Do not enter page subtotals. Enter the amount from column (g) on Form 720-CS, Part II, line 1, in the column for the
applicable PC .
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720-CS
Form
(Rev. 9-2010)

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