Form Mf-360 - Consolidated Gasoline Monthly Tax Return Page 3

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Enter the correct amount of gallons on this page.
A
B
C
D
From
Gasoline/Aviation
K-1/K-2
All Other
Totals
Section A: Receipts
Schedule
Gasoline/Gasohol
Kerosene
Products
1 Gallons received, gasoline tax or inspection fee paid
1A
2 Gallons received from licensed distributors or oil inspection distributors, tax
unpaid
2
3 Gallons of non-taxable fuel received and sold or used for a taxable purpose
2K
4 Gallons received from licensed distributors on exchange agreements, tax unpaid
2X
5 Gallons imported directly to customer
3
6 Gallons imported into own storage
4
7 Diversions into Indiana
11
8 Total receipts - add Lines 1-7, carry total (Column D) to Section 2, Line 1
9 Total receipts - add Lines 1-7, carry total (Column D) to Section 3, Line 1
A
B
C
D
From
Gasoline/Aviation
K-1/K-2
All Other
Totals
Section B: Disbursements
Schedule
Gasoline/Gasohol
Kerosene
Products
1 Gallons delivered, tax collected
5
2 Diversion out of Indiana
11
3 Gallons sold to licensed distributors, tax not collected
6D
4 Gallons disbursed on exchange
6X
5 Gallons exported (must be filed in duplicate)
7
6 Gallons delivered to U.S. Government - tax exempt
8
7 Gallons delivered to licensed marina fuel dealers
10A
8 Gallons delivered to licensed aviation fuel dealers
10B
9 Miscellaneous deduction - theft/loss
E-1
9a Miscellaneous deduction - off road, other
E-1
10 Total non-taxable disbursements - add Lines 2-9a, carry total to Section 2, Line 2
11 Total non-taxable disbursements - add Lines 2-6, carry total to Section 3, Line 2

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