Form Mf-360x - Amended Consolidated Gasoline Monthly Tax Return Page 2
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1
2
3Enter the corrected total amount of gallons on this page.
Gasoline/
Totals
From
Aviation
K-1/K-2
All Other
Gasoline/Gasohol
Kerosene
Schedule
Products
Section A: Receipts
D
A
C
B
1.
Gallons received, excise tax paid
1A
2.
Gallons received from licensed distributors or oil inspection
2
distributors, tax unpaid
3.
Gallons of non-taxable fuel received and sold or used for a taxable
2K
purpose
4.
Gallons received from licensed distributors on exchange agreements,
2X
tax unpaid
5.
Gallons imported directly to customer
3
6.
Gallons imported into own storage
4
7.
Diversions into Indiana
11
8.
Total receipts - add Lines 1-7, carry total (Column D) to, Section 2,
Line 1 on front
9.
Total receipts - add Lines 1-7, carry total (Column D) to, Section 3,
Line 1 on front
Totals
Gasoline / Aviation
K-1/K-2
All Other
From
Section B: Disbursement
Gasoline / Gasohol
Kerosene
Schedule
Products
D
A
B
C
1.
Gallons delivered, tax collected
5
2.
Diversions out of Indiana
11
3.
Gallons sold to licensed distributors, tax not collected
6D
4.
Gallons disbursed on exchange
6X
5.
Gallons exported (must be filed in duplicate)
7
6.
Gallons delivered to U.S. Government - tax exempt
8
7.
Gallons delivered to licensed marina fuel dealers
10A
8.
Gallons delivered to licensed aviation fuel dealers
10B
9.
Miscellaneous deduction - theft/loss
E-1
9a. Miscellaneous deduction - off road, other
E-1
10. Total non-taxable disbursements - add Lines 2-9a, carry total to Section 2,
Line 2 on front.
11. Total non-taxable disbursements - add Lines 2-6, carry total to Section 3,
Line 2 on front
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