Form Co00651 - Individual Vehicle Mileage And Fuel Report - 1999

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Individual Vehicle Mileage and Fuel Report
IFTA
IDAHO
To be completed by driver for each trip
Read instructions and see example on reverse side
Fuel Type
Name (Fuel Filer/IRP Registrant)
Name of Fuel Filer (if other than IRP Registrant)
Power Unit Vehicle Identification No. or Unit No.
Power Unit Fleet Number
Trip Origin (City and State)
Name of Driver(s)
Destination (City and State)
MILEAGE INFORMATION
FUEL INFORMATION
Date
Highways
Jurisdiction
Jurisdiction
Fuel Invoice
Gallons
Odometer *
Name and Address of Fuel Stop/
Date of
Name
Miles
Number
Purchased
Used
Reading
Intermediate Stop
Stop
>
ODOMETER READING AT BEGINNING OF TRIP
Odometer Reading When
Exiting Jurisdiction
<
>
>
TOTAL TRIP MILES
TOTAL FUEL
ODOMETER READING AT END OF TRIP
*
CO00651
FORM IS SUGGESTED, NOT REQUIRED - KEEP FOR YOUR RECORDS - DO NOT SUBMIT WITH YOUR TAX REPORT
If hubodometer miles are used, indicate "HUB."
6-30-99

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