Schedule D - Sales And/or Use Of Special Fuels
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1Motor Fuels Tax
State of New Jersey
Schedule D
Division of Taxation
(11/09)
SCHEDULE D
Sales and/or Use of Special Fuels
This Schedule is to be completed by all persons holding a Seller-User’s License and who operate their own dispensing pump.
(Attach Riders if Necessary)
Name of Licensee
Federal Identification Number
Month / Year
1.
Gallonage Pump Totalizer Reading(s) of Special Fuels for the report month:
(B)
(A)
Gallonage Pumped
Opening Totalizer Reading
Closing Totalizer Reading
Product Type *
Pump Serial Number
Column A Minus Column B
(Beginning of Report Month)
(End of Report Month)
TOTAL GALLONAGE PUMPED __________________________
2.
IMPORTANT:
Please indicate below if there has been a malfunction or replacement of a gallon totalizer and/or pump during the
report month.
New
Product
Old
Old
New
Totalizer Reading
Date
Totalizer Reading
Date
Type*
Pump Serial Number
Pump Serial Number
* Product Type:
1. Kerosene
2. No. 2 fuel oil
3. Diesel fuel, No. 1 diesel fuel, No. 2 diesel fuel and enhanced No. 2 fuel oil;
4. Propane
5. Compressed Natural Gas
6. Bio-Diesel
7. Other _________________________________________________________
THIS FORM MAY BE REPRODUCED
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