Form 199-E - Schedule 5 - Vehicle And Mileage Record

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Form 199-E
Special Fuel Use Tax Report to Motor Fuel Division - Oklahoma Tax Commission
Revised 1-2012
Schedule 5
Vehicle and Mileage Record
Name of Special Fuel User
OTC License Number
Month
Year
Summary Totals All States
Office
Mileage by Unit
Name of State
Average Miles
Total Miles
Total Gallons
Total Gallons
Oklahoma Operations Only
Use
per Gallon
Traveled
Consumed
Put in Vehicles
Column 1
Column 2
Column 3
Column 4
Column 5
Column 6
Column 7
Only
Unit Number
Miles Traveled
Diesel
LPG
Diesel
LPG
Diesel
LPG
Diesel
LPG
Diesel,
LPG, Butane -
Oklahoma
Kerosene, etc.
Propane
Texas
Kansas
Arkansas
Missouri
New Mexico
Colorado
Others
TOTALS

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