Form Smf - 10 Draft - Supplier Of Motor Fuels Report Page 15
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19Division use only — DLN Stamp
Division use only — Date Stamp
Period
Attach to:
mm
yyyy
Form SMF-200
Supplier Diesel & Kerosene Return
Pursuant to NJSA 54:39-101 et seq
10-2010
SMF205
Schedule of Taxable Diesel & Kerosene Sales Originating Outside NJ
Organize data by Seller ID#and include a summary of gallons per Seller. Use additional SMF205's if needed.
State of Origin
Licensee
Licensee #
Product
Date Seller ID#
Seller
Carrier ID #
Carrier
Gallons
Code
Document #
Destination City
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Total gallons this page
Total Gallons for SMF205
page
of
Report this amount on
Line 6, Form SMF200
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