Form Rpd-41306b - Combined Fuel Tax Report For Distributors, Suppliers And Wholesalers Schedule Of Receipts

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State of New Mexico - Taxation & Revenue Department
RPD-41306B
REV. 07/2010
COMBINED FUEL TAX REPORT FOR DISTRIBUTORS, SUPPLIERS AND WHOLESALERS
SCHEDULE OF RECEIPTS
Distributor/supplier/wholesaler name
FEIN / CRS
Schedule type
Month/Year
PRODUCT TYPE - (CHECK ONE BOX)
SCHEDULE TYPE:
1
Gallons acquired tax paid
065 Gasoline
099 99% vegetable oil or animal fat
1A Gallons received in New Mexico and tax paid at a Texas terminal
123 Ethanol
170 Biodiesel
2A Gallons received from a New Mexico terminal
160 Diesel
Other products ________________ (Indicate product code)
2B Gallons produced and/or blended
2C Gallons received when transported off Indian land
3
Gallons imported from another state
4
Gallons imported directly into NM Indian land - tax exempt
Page _______ of _______
(1)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(2)
(3)
Carrier
Carrier
Seller
Seller
Date
B O L
Net
Gross
Mode
name
FEIN
terminal # or name
FEIN
received
number
gallons
gallons
POINT OF
ORIGIN
DESTINATION
Total gallons
RPD41306B

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