Form 87 - Nebraska Motor Fuels Terminal Operator Schedule Of Receipts

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FORM
Nebraska Motor Fuels Terminal Operator Schedule of Receipts
87
Page ____ of ____
Name as Shown on Report
Terminal Code
Terminal Code
Federal Employer Identification Number
Nebraska Identification Number
Reporting Month/Year
Reporting Month/Year
PRODUCT CODES – Check Only One
061 Nat. Gasoline (Denaturant)
130 Aviation Jet Fuel
D00 Dyed Biodiesel
065 Gasoline
160 Undyed Diesel
170 or B01-B99 Undyed Biodiesel Blend
123 or E00 Ethanol-Alcohol
228 Dyed Diesel
171 or D01-D99 Dyed Biodiesel Blend
124 or E01-E99 Gasohol
B00 Undyed Biodiesel
125 Aviation Gasoline
(5)
(7)
(2)
(8)
(4)
(6)
(1)
(3)
Position Holder
Bill of Lading/
Carrier
Net
Position Holder
Date
Carrier Name
Mode
FEIN
Manifest No.
FEIN
Name
Gallons
TOTAL
• Must be Filed With Your Terminal Report

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Parent category: Financial
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