06-153
(Rev.8-09/4)
PRINT
b.
a.
<choose one>
DO NOT WRITE IN SHADED AREAS
TYPE or PRINT
TEXAS SCHEDULE OF TAXABLE SALES TO UNLICENSED
c. Taxpayer number
d. Filing period
ENTITIES IN THE BULK TRANSFER/TERMINAL SYSTEM
-- TAX COLLECTED BY SUPPLIER/PERMISSIVE SUPPLIER
(Item 11)
f.
e. Taxpayer name
1. Transporter name
2. Transporter taxpayer number
3. Purchaser name
4. Purchaser taxpayer number
5. Product type
6. Mode
7. Date removed
8. Shipping doc. no.
9. Terminal control number
10. Invoiced gallons
1. Transporter name
2. Transporter taxpayer number
3. Purchaser name
4. Purchaser taxpayer number
5. Product type
6. Mode
7. Date removed
8. Shipping doc. no.
9. Terminal control number
10. Invoiced gallons
1. Transporter name
2. Transporter taxpayer number
3. Purchaser name
4. Purchaser taxpayer number
5. Product type
6. Mode
7. Date removed
8. Shipping doc. no.
9. Terminal control number
10. Invoiced gallons
1. Transporter name
2. Transporter taxpayer number
3. Purchaser name
4. Purchaser taxpayer number
5. Product type
6. Mode
7. Date removed
8. Shipping doc. no.
9. Terminal control number
10. Invoiced gallons
1. Transporter name
2. Transporter taxpayer number
3. Purchaser name
4. Purchaser taxpayer number
5. Product type
6. Mode
7. Date removed
8. Shipping doc. no.
9. Terminal control number
10. Invoiced gallons
1. Transporter name
2. Transporter taxpayer number
3. Purchaser name
4. Purchaser taxpayer number
5. Product type
6. Mode
7. Date removed
8. Shipping doc. no.
9. Terminal control number
10. Invoiced gallons
1. Transporter name
2. Transporter taxpayer number
3. Purchaser name
4. Purchaser taxpayer number
5. Product type
6. Mode
7. Date removed
8. Shipping doc. no.
9. Terminal control number
10. Invoiced gallons
TOTAL INVOICED GALLONS
TOTAL INVOICED GALLONS
FOR ALL PAGES
(Sum of Item 10)
(Enter on Item 11 of
FOR THIS PAGE ONLY
Texas Fuels Tax Report, Form 06-168)