Form R-5291 - Schedule A - Motor Fuel Tax Multiple Schedule Of Receipts

Download a blank fillable Form R-5291 - Schedule A - Motor Fuel Tax Multiple Schedule Of Receipts in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form R-5291 - Schedule A - Motor Fuel Tax Multiple Schedule Of Receipts with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

R-5291 (7/06)
Page _____ of _____
Schedule A
Motor Fuel Tax Multiple Schedule of Receipts
Company Name
LA Revenue Account Number
Type of Schedule
Product Type
Filing Period
Type of Schedule
Mode of Transport
Product Type (Only one product type per page)
1
Gallons received tax and inspection fee paid
B = Barge
PL = Pipeline
065 – Gasoline
130 – Jet Fuel
228 – Dyed Diesel
2
Gallons received inspection fee paid
J = Truck
ST = Stationary Transfer
123 – Alcohol
072 – Dyed Kerosene
170 – Clear Biodiesel
3
Gallons imported without Louisiana tax or fee paid
R = Rail
BA = Book Adjustment
124 – Gasohol
142 – Clear Kerosene
171 – Dyed Biodiesel
4
Gallons of non-motor fuel product used in blending
S = Ship
125 – Aviation Gasoline
160 – Clear Diesel
Other _______________
5
Gallons blended
(2)
(5)
(3)
(4)
(1)
(6)
(7)
Seller
City, State of
Doc.
Net
Name
Rev. ID
Origin
Number
Gallons
Date
Destination
Mode
Carrier Name
Total

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Form R-5289 - Dealer's Motor Fuels Tax And Inspection Fee Report Form R-5289 - Dealer's Motor Fuels Tax And Inspection Fee Report Financial
Form R-5290 - Schedule B - Motor Fuel Tax Multiple Schedule Of Disbursements Form R-5290 - Schedule B - Motor Fuel Tax Multiple Schedule Of Disbursements Financial
Form R-5401 - Schedule C - Motor Fuel Tax Multiple Schedule Of Terminal Rack Removals Form R-5401 - Schedule C - Motor Fuel Tax Multiple Schedule Of Terminal Rack Removals Financial
Form R-5402 - Schedule D - Motor Fuel Tax Multiple Schedule Of State Diversion Corrections Form R-5402 - Schedule D - Motor Fuel Tax Multiple Schedule Of State Diversion Corrections Financial
Form Ga-1a - Motor Fuel Tax, Multiple Schedule Of Gasoline Receipts Form Ga-1a - Motor Fuel Tax, Multiple Schedule Of Gasoline Receipts Financial
Form Ga-1a - Motor Fuel Tax Multiple Schedule Of Gasoline Receipts Form Ga-1a - Motor Fuel Tax Multiple Schedule Of Gasoline Receipts Financial
Form R-5290 - Motor Fuel Tax Multiple Schedule Of Disbursements - Louisiana Department Of Revenue Form R-5290 - Motor Fuel Tax Multiple Schedule Of Disbursements - Louisiana Department Of Revenue Financial
Form Mf-52b (special Fuel) - Motor Fuel Tax Multiple Schedule Of Disbursements Special Fuel Form Mf-52b (special Fuel) - Motor Fuel Tax Multiple Schedule Of Disbursements Special Fuel Financial
Schedule B Motor Fuel Tax Multiple Schedule Of Disbursements Form - Louisiana Department Of Revenue Schedule B Motor Fuel Tax Multiple Schedule Of Disbursements Form - Louisiana Department Of Revenue Financial
Form Mf-52b - Motor Fuel Tax Multiple Schedule Of Disbursements Special Fuel - 2004 Form Mf-52b - Motor Fuel Tax Multiple Schedule Of Disbursements Special Fuel - 2004 Financial

Related Categories

Parent category: Financial
Download
Go