Schedule 2 (Form Rv-F1302101) - Addendum For Compliance

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TENNESSEE DEPARTMENT OF REVENUE
SCHEDULE 2
NAME
ADDENDUM FOR COMPLIANCE
DATE
1. What type of business will the applicant operate and what types of fuel will apply to that business in Tennessee?
Check all that apply.
#2
AV
LP
Gas
DF
Fuel
Kero
Alcohol Fuels
Other
Jet Fuel
Gas
Gas
Oil
Pipeline or River Terminal
Bulk Plant
Transport Trucks
Delivery Trucks
Retail Stations
Convenience Stores
Consignment Sales
Other (Specify below)
If other, specifically describe the business activities for fuel type:
2. Indicate the means of transport for these fuels:
Pipeline
Truck Transport
Railroad Tank Car
Marina Vessel
Tank Wagon
Other
IF OTHER, describe:
3. Number of Tennessee licensed vehicles you operate on Tennessee highways:
Gasoline
Diesel
Propane/CNG
Powered
Powered
Powered
Greater than 10,000 and less than 26, 001 lbs.
Greater than 26,000 lbs.
withdraw from your own bulk storage, or
4. If you use undyed diesel in company operated vehicles, do you
purchase from retail locations?
5. If you maintain bulk storage in Tennessee, list all bulk plant locations and tank capacities by fuel type. (If necessary,
attach separate sheet.)
Capacity
Bulk Plant location
Tank ID
Fuel Type
6. Check the type(s) of accounts to which you will sell fuels other than gasoline in Tennessee:
Private Consumers
Other Oil Companies
Limited Users
Retail Service Centers
Governmental
Prepaid Users
Agricultural
Aviation
Truck Lines
Other
If other, please describe:
7. If you sell to governmental agencies, will you sell by means of:
Fleet Card
Oil Company Credit Card
Bulk Delivery
If fleet card, give name of fleet card company
8. Are you or will you be required to file Form 720, Quarterly Federal Excise Tax Return?
Yes
No
Federal 637 Exemption Number (if applicable):
9. List terminal code numbers for each terminal selling product for destination to Tennessee:
Terminal Code Number
Location
T -
-
-
T -
-
-
T -
-
-
T -
-
-
T -
-
-
RV-F1302101

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