Form R-5394 - Schedule H - Terminal Operator Schedule Of Inventories

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R-5394 (7/06)
Page _____ of _____
Schedule H
Terminal Operator Schedule of Inventories
Company Name
LA Revenue Account Number TCN
Product Type
Filing Period
Product Type (Only one product type per page)
065 – Gasoline
124 – Gasohol
130 – Jet Fuel
142 – Clear Kerosene
228 – Dyed Diesel
171 – Dyed Biodiesel
123 – Alcohol
125 – Aviation Gasoline
072 – Dyed Kerosene
160 – Clear Diese
170 – Clear Biodiesel
Other ________________
(1)
(2)
(3)
(4)
(5)
(6)
Position Holder
Beginning
Total
Total
Gain or
Ending
Inventory
Receipts
Disbursements
(Loss)
Inventory
Name
FEIN
Totals

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