Form 199-A - Schedule 1 - Receipts Of Special Fuel Imported Into This State

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Form 199-A
Revised 1-2012
Special Fuel Use Tax Report to Motor Fuel Division - Oklahoma Tax Commission
Schedule 1
Receipts of Special Fuel Imported into this State
Tank Car No.
Gallons
Delivery
Point
Point
or
of
Invoice
of
of
Transporter
LPG, Butane,
Date
Number
Received From
Origin
Delivery
OTC No.
Propane, etc.
Total Receipts of Special Fuel Imported into the State of Oklahoma (Enter on Form 199, Line 2A)

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