06-156
(Rev.3-06/3)
PRINT
b.
<choose one>
a.
DO NOT WRITE IN SHADED AREAS
TYPE or PRINT
TEXAS SCHEDULE OF GALLONS SOLD TAX-FREE
c. Taxpayer number
d. Filing period
TO AVIATION FUEL DEALERS
(Item 14)
f.
e. Taxpayer name
1. Transporter name
2. Transporter taxpayer number
3. Purchaser name
4. Purchaser taxpayer number
5. Prod. type
6. Mode
7. Date removed
8. Shipping doc. no.
9. Terminal control number
10. Invoiced gallons
11. Mark this box if
these gallons were
purchased tax-paid.
1. Transporter name
2. Transporter taxpayer number
3. Purchaser name
4. Purchaser taxpayer number
5. Prod. type
6. Mode
7. Date removed
8. Shipping doc. no.
9. Terminal control number
10. Invoiced gallons
11. Mark this box if
these gallons were
purchased tax-paid.
1. Transporter name
2. Transporter taxpayer number
3. Purchaser name
4. Purchaser taxpayer number
5. Prod. type
6. Mode
7. Date removed
8. Shipping doc. no.
9. Terminal control number
10. Invoiced gallons
11. Mark this box if
these gallons were
purchased tax-paid.
1. Transporter name
2. Transporter taxpayer number
3. Purchaser name
4. Purchaser taxpayer number
5. Prod. type
6. Mode
7. Date removed
8. Shipping doc. no.
9. Terminal control number
10. Invoiced gallons
11. Mark this box if
these gallons were
purchased tax-paid.
1. Transporter name
2. Transporter taxpayer number
3. Purchaser name
4. Purchaser taxpayer number
5. Prod. type
6. Mode
7. Date removed
8. Shipping doc. no.
9. Terminal control number
10. Invoiced gallons
11. Mark this box if
these gallons were
purchased tax-paid.
1. Transporter name
2. Transporter taxpayer number
3. Purchaser name
4. Purchaser taxpayer number
5. Prod. type
6. Mode
7. Date removed
8. Shipping doc. no.
9. Terminal control number
10. Invoiced gallons
11. Mark this box if
these gallons were
purchased tax-paid.
1. Transporter name
2. Transporter taxpayer number
3. Purchaser name
4. Purchaser taxpayer number
5. Prod. type
6. Mode
7. Date removed
8. Shipping doc. no.
9. Terminal control number
10. Invoiced gallons
11. Mark this box if
these gallons were
purchased tax-paid.
TOTAL INVOICED GALLONS
TOTAL INVOICED GALLONS
FOR ALL PAGES
(Sum of Item 10)
(Enter on Item 14 of
FOR THIS PAGE ONLY
Texas Fuels Tax Report, Form 06-168)