Form Ft-942 - Diesel Motor Fuel And Motor Fuel Transporter'S Monthly Report Page 2
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2FT-942 (9/11) (back)
Business name
EIN
Month-year
Part 2 — Exports — Transportation of fuel from a point inside New York State to a point outside the state
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Date shipped
Place of origin
Name of exporter
EIN of the
Place of destination
Mode of
Identification number
Gallons
Product
*
TCN or name, city/state
exporter (required)
TCN or name, city/state
delivery
of transportation
code
(mm-dd)
equipment
(see instr.)
*
From Publication 902, Product Codes for Fuels
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