Form 06-159 - Texas Schedule Of Gallons Sold Tax-Free To Exempt Entities
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1
206-159
(Rev.8-09/4)
b.
PRINT
<choose one>
a.
DO NOT WRITE IN SHADED AREAS
TYPE or PRINT
TEXAS SCHEDULE OF GALLONS SOLD
c. Taxpayer number
d. Filing period
TAX-FREE TO EXEMPT ENTITIES
(Item 17)
f.
e. Taxpayer name
1. Transporter name
2. Transporter taxpayer number
3. Purchaser name
4. Purchaser taxpayer number
5. Exempt type 6. Product type
7. Mode
8. Date removed
9. Shipping doc. no.
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. Exempt type 6. Product type
7. Mode
8. Date removed
9. Shipping doc. no.
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. Exempt type 6. Product type
7. Mode
8. Date removed
9. Shipping doc. no.
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. Exempt type 6. Product type
7. Mode
8. Date removed
9. Shipping doc. no.
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. Exempt type 6. Product type
7. Mode
8. Date removed
9. Shipping doc. no.
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. Exempt type 6. Product type
7. Mode
8. Date removed
9. Shipping doc. no.
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. Exempt type 6. Product type
7. Mode
8. Date removed
9. Shipping doc. no.
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 17 of
FOR THIS PAGE ONLY
Texas Fuels Tax Report, Form 06-168)
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