Form Dmf-26a - Monthly Carriers Report Of Liquid Fuels And Fuels Delivered Schedule
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1DMF-26A (07-13)
MONTHLY CARRIERS REPORT OF LIQUID FUELS
BUREAU OF MOTOR AND ALTERNATIVE FUEL TAXES
AND FUELS DELIVERED SCHEDULE
5TH FLOOR, STRAWBERRY SQUARE
HARRISBURG PA 17128-0646
Carrier’s Name
FEIN
Schedule Type
MONTH/YEAR
PRODUCT TYPE (Check Only One)
Schedule Type:
Liquid Fuels:
Fuels:
□
□
1A - Deliveries Exported From Pennsylvania
65 - Gasoline
160 - Clear Diesel
□
□
2A - Deliveries Imported Into Pennsylvania
124 - Gasohol
142 - Kerosene
□
□
3A - Intrastate Deliveries In Pennsylvania
130 - Jet Fuel
124 - E-85
□
□
125 - Aviation Gasoline
170 - Biodiesel
□
160 - Ultra - Low Sulfur Diesel
□
Other
(Specify)
Seller
Delivered to
(4)
(5)
(1)
(2)
(3)
(6)
(7)
(8)
(10)
(9)
Origin
Name
Seller’s
FEIN
Mode
Address
FEIN
Date
BOL/Invoice
Gross or Net
(City, State)
Delivered
Gallons
Number
Name
TOTAL
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