Form Pet 368 - Blender'S Return Page 4

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TAX MONTH _________________
_______________________________________________
RETURN LINE NO. _____________
ACCOUNT NAME
COLUMN ____________________
_______________________________________________
PRODUCT
BLENDER'S TAX RETURN SCHEDULE (Attach to PET 368)
ACCOUNT NO.
SALES OR OTHER USE
SHIPPING
OTHER USE
DATE
PAPER NO.
OR SOLD TO:
ORIGIN
DESTINATION
CARRIER
PRODUCT
GALLONS
Total Gallons Sold or Used (Carry to Line 4)
RV-F1400901

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Parent category: Financial
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