Form 06-152 - Texas Schedule Of Blended Gallons Sold

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06-152
(Rev.3-06/3)
PRINT
b.
<choose one>
a.
DO NOT WRITE IN SHADED AREAS
TYPE or PRINT
TEXAS SCHEDULE OF
c. Taxpayer number
d. Filing period
BLENDED GALLONS SOLD
(Item 10)
f.
e. Taxpayer name
1. Purchaser name
2. Purchaser taxpayer number
3. Product type
4. Date removed
5. Shipping doc. no.
6. Invoiced gallons
1. Purchaser name
2. Purchaser taxpayer number
3. Product type
4. Date removed
5. Shipping doc. no.
6. Invoiced gallons
1. Purchaser name
2. Purchaser taxpayer number
3. Product type
4. Date removed
5. Shipping doc. no.
6. Invoiced gallons
1. Purchaser name
2. Purchaser taxpayer number
3. Product type
4. Date removed
5. Shipping doc. no.
6. Invoiced gallons
1. Purchaser name
2. Purchaser taxpayer number
3. Product type
4. Date removed
5. Shipping doc. no.
6. Invoiced gallons
1. Purchaser name
2. Purchaser taxpayer number
3. Product type
4. Date removed
5. Shipping doc. no.
6. Invoiced gallons
1. Purchaser name
2. Purchaser taxpayer number
3. Product type
4. Date removed
5. Shipping doc. no.
6. Invoiced gallons
1. Purchaser name
2. Purchaser taxpayer number
3. Product type
4. Date removed
5. Shipping doc. no.
6. Invoiced gallons
TOTAL INVOICED GALLONS
TOTAL INVOICED GALLONS
FOR ALL PAGES
(Sum of Item 6)
(Enter on Item 10 of
FOR THIS PAGE ONLY
Texas Fuels Tax Report, Form 06-168)

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Parent category: Financial
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