Form 06-185 - Amended Schedule Of Gallons Sold Tax-Free To Exempt Entities
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1
206-185
-- AMENDED --
(Rev.3-06/3)
b.
<choose one>
a.
DO NOT WRITE IN SHADED AREAS
TYPE or PRINT
TEXAS SCHEDULE OF GALLONS SOLD
c. Taxpayer number
d. Filing period
TAX-FREE TO EXEMPT ENTITIES
(Item 17)
f.
e. Taxpayer name
1. Transporter name
2. Transporter taxpayer number
LOCATOR NUMBER
3. Purchaser name
4. Purchaser taxpayer number
5. Exempt type 6. Product type
7. Mode
8. Date removed
9. Shipping doc. no.
10. Invoiced gallons
11. Were these gallons
purchased tax-paid?
1 =YES 0 =NO
1. Transporter name
2. Transporter taxpayer number
LOCATOR NUMBER
3. Purchaser name
4. Purchaser taxpayer number
5. Exempt type 6. Product type
7. Mode
8. Date removed
9. Shipping doc. no.
10. Invoiced gallons
11. Were these gallons
purchased tax-paid?
1 =YES 0 =NO
1. Transporter name
2. Transporter taxpayer number
LOCATOR NUMBER
3. Purchaser name
4. Purchaser taxpayer number
5. Exempt type 6. Product type
7. Mode
8. Date removed
9. Shipping doc. no.
10. Invoiced gallons
11. Were these gallons
purchased tax-paid?
1 =YES 0 =NO
1. Transporter name
2. Transporter taxpayer number
LOCATOR NUMBER
3. Purchaser name
4. Purchaser taxpayer number
5. Exempt type 6. Product type
7. Mode
8. Date removed
9. Shipping doc. no.
10. Invoiced gallons
11. Were these gallons
purchased tax-paid?
1 =YES 0 =NO
LOCATOR NUMBER
1. Transporter name
2. Transporter taxpayer number
3. Purchaser name
4. Purchaser taxpayer number
5. Exempt type 6. Product type
7. Mode
8. Date removed
9. Shipping doc. no.
10. Invoiced gallons
11. Were these gallons
purchased tax-paid?
1 =YES 0 =NO
1. Transporter name
2. Transporter taxpayer number
LOCATOR NUMBER
3. Purchaser name
4. Purchaser taxpayer number
5. Exempt type 6. Product type
7. Mode
8. Date removed
9. Shipping doc. no.
10. Invoiced gallons
11. Were these gallons
purchased tax-paid?
1 =YES 0 =NO
1. Transporter name
2. Transporter taxpayer number
LOCATOR NUMBER
3. Purchaser name
4. Purchaser taxpayer number
5. Exempt type 6. Product type
7. Mode
8. Date removed
9. Shipping doc. no.
10. Invoiced gallons
11. Were these gallons
purchased tax-paid?
1 =YES 0 =NO
TOTAL INVOICED GALLONS
(Sum of Item 10)
FOR THIS PAGE ONLY
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