Form Pet 366 - Compressed Natural Gas User'S Tax Return Page 2

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For additional information, contact the Taxpayer Services Division in one of our Department of Revenue Offices:

Knoxville

Chattanooga

Jackson

Nashville

Memphis

(423) 594-6100

(423) 634-6266

(901) 423-5747

(615) 741-2594

(901) 537-2904

Room 606

Suite 350

Room 405 B

3rd Floor

Suite 418

State Office Building

Lowell Thomas Building

Andrew Jackson Building

White Station Tower

531 Henley Street

540 McCallie Avenue

500 Deaderick Street

225 Martin Luther King Blvd.

5050 Poplar Avenue

Tennessee residents can also call our statewide toll free number at 1-800-342-1003. Out-of-state callers must dial (615) 741-2594

SCHEDULE A

COMPRESSED NATURAL GAS PUT INTO TANK OF VEHICLE(S) LICENSED TO USE PUBLIC HIGHWAYS

This schedule should include all vehicles licensed to use Tennessee highways. The column to the right on the schedule is used to record total fuel tax-due, placed into individual vehicles.

_______________________________________________________________________________________________________

VEHICLE

MAKE OF

ODOMETER READING

MILES

_______________________________________________________________________________________________________

LICENSE #

VEHICLE

FIRST OF MO.

LAST OF MO.

TRAVELED

GALLONS OF FUEL PLACED IN VEHICLE