Form R-5433 - Fuel Floor Stock Tax Schedule Of Fuel In Storage - No Inspection Fee Paid

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R-5433 (7/06)
Page______ of_______
Fuel Floor Stock Tax
Schedule of Fuel in Storage –
No Inspection Fee Paid
On the schedule below, enter the inventories of fuel, other than at a pipeline terminal, on which the Louisiana inspection
fee has not been paid. The inventory should include fuel in-transit on June 30, 2006.
Company Name
LA Revenue Account Number
Filing Period
Product Type
07/06
Please list only one product type per page.
Product Type
065 – Gasoline
125 – Aviation Gasoline
142 – Clear Kerosene
170 – Clear Biodiesel
123 – Alcohol
130 – Jet Fuel
160 – Clear Diesel
171 – Dyed Biodiesel
124 – Gasohol
072 – Dyed Kerosene
228 – Dyed Diesel
Other _________________________________
Address of Fuel Storage or Transit Vehicle License
City/State
Gallons in Storage
Gallons in Transit
Total this page
Total this Product Type

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