Form Mf 2-1 - Licensed Dealer'S Schedule Of Receipts

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MF 2-1
Rev. 11/08
Reset Form
P.O. Box 530
Columbus, OH 43216-0530
Licensed Dealer’s Schedule of Receipts
Dealer’s Name
FEIN
Schedule Type
Month/Year
Schedule Type
Product Type (check one)
1. Received tax paid
65 Gasoline
226 High sulfur diesel (dyed)
2. Received from other licensed dealers tax unpaid
142 Kerosene
227 Low sulfur diesel (dyed)
3. Imported into Ohio
160 Diesel fuel (clear)
Other products
(1)
(7)
(2)
(3)
(4)
(5)
(6)
(8)
(10)
Carrier
Acquired
Seller’s
Date
Document
State of Origin
Gross
Carrier Name
Received
FEIN
Mode
From
FEIN
Number
Sched 3 Only
Gallons
Total gallons

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Parent category: Financial
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