Division use only — DLN Stamp
Division use only — Date Stamp
Period
Attach to:
mm
yyyy
Form SMF-100
Supplier Gasoline Return
Pursuant to NJSA 54:39-101 et seq
10-2010
Schedule of Taxable Gasoline Sales Originating Outside NJ
SMF105
Organize data by Seller ID#and include a summary of gallons per Seller. Use additional SMF105's if needed.
State of Origin
Licensee
Licensee #
Product
Date Seller ID#
Seller
Carrier ID #
Carrier
Gallons
Code
Document #
Destination City
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Total gallons this page
Total Gallons for SMF105
page
of
Report this amount on
Line 6, Form SMF100