Form Mvf-3 - Terminal Operator'S Monthly Gasoline Activity Schedule
ADVERTISEMENT
1
2
3
4Department of Revenue Services
Form MVF-3
Excise Taxes Unit
Terminal Operator’s Monthly Gasoline Activity Schedule
450 Columbus Blvd Ste 1
Hartford CT 06103-1837
(Rev. 02/17)
Due Date: Taxpayers must fi le schedules for each calendar month with Form O-MF, Motor Vehicle Fuels Tax Return.
Name of terminal operator
Terminal operator Connecticut Tax Registration Number
Month of
Address of terminal operator
Telephone number
Customer name
Customer Connecticut Tax Registration No.
Part 1 - Reconciliation
Type of Gasoline by Gross Gallons
Unleaded Regular
Unleaded Mid-Grade
Unleaded Premium
Total Gross Gallons
1.
Opening physical inventory
1.
2.
Receipts: Enter Total from Part 2.
2.
3.
Subtotal: Add Lines 1 and 2.
3.
4.
Disbursements: Enter Total from Part 3.
4.
5.
Ending Inventory: Subtract Line 4 from Line 3.
5.
6.
Physical inventory taken on last day of month.
6.
7.
Loss or Gain: Subtract Line 6 from Line 5.
7.
Part 2 - Receipts
Type of Gasoline by Gross Gallons
Name of
Date of Delivery
Method of Delivery
Transporter or Vessel
Unleaded Regular
Unleaded Mid-Grade
Unleaded Premium
Total Gross Gallons
Page 2, Part 2 totals brought forward
Total receipts - Transfer to Part 1, Line 2
Part 3 - Disbursements
Type of Gasoline by Gross Gallons
Unleaded Regular
Unleaded Mid-Grade
Unleaded Premium
Total Gross Gallons
Disbursements by truck or tank wagon
List other disbursement methods (barge, etc.)
Page 3, Part 3 totals brought forward
Total disbursements - Transfer to Part 1, Line 4
Page 1 of 4
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial