Form Com/mftb-048 - Motor Fuel Tax Schedule Of Receipts

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MATT regulatory division
p.o. box 1751
annapolis, md 21401-1751
motor fuel tax
motor fuel tax schedule of receipts
410-260-7138
1-888-784-0141
company name
license #
fein #
schedule type & product code
month/year
product codes
types of schedule
054 - propane (lpG)
125 - aviation Gas
160 - uNdyed diesel
1 Gallons received tax paid
065 - GasoliNe
130 - jet fuel
170 - biodiesel - undyed
2 Gallons received from licensed motor fuel distributors
072 - dyed kerosene
142 - undyed kerosene
224 - compr. natural Gas (cnG)
tax unpaid
092 - other
150 - #1 fuel oil
225 - liquid natural Gas (lnG)
3 Gallons imported from another state direct to customers
124 - Gasohol ethanol blend
152 - heatinG oil
228 - dyed diesel
4 Gallons imported from another state into tax-free storaGe
241 - ethanol
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
carrier
carrier
mode
point of
acquired
sellers
date
document
billed
other
name
fein
oriGin
from
FEIN number
receiVED
number
Gallons
Gallons
destination
total
com/mft-048 rev. 7/07
see instructions on reverse side

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