Form Rpd-41308a - Fuel Retailer Report Schedule Of Gasoline Purchases

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State of New Mexico - Taxation & Revenue Department
RPD-41308A
INT. 12/2005
FUEL RETAILER REPORT
SCHEDULE OF GASOLINE PURCHASES
Retailer Name
FEIN / SSN / BN
Schedule Type
Month/Year
SCHEDULE TYPE:
PRODUCT TYPE - (CHECK ONE BOX)
1
Gallons Received Excise Tax-Paid
065 Gasoline
2
Gallons Received Excise Tax-Unpaid
241 Ethanol
124 Gasohol
092 Other ______________
See pages 4 & 5 of instructions for additional product codes
(2)
(1)
(3)
(4)
(5)
Distributor Purchased From
Distributor's
Date
BOL or Invoice
Gallons
Name/Location
FEIN/SSN/BN
Received
Number
Purchased
Total Gallons
RPD41308A

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