Form Smf-10 - Supplier Of Motor Fuels Report Page 14
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31Division use only — DLN Stamp
Division use only — Date Stamp
Period
Attach to:
mm
yyyy
Form SMF100,
Pursuant to NJSA 54:39-101 et seq
Supplier Schedule of Motor Fuels Tax Due
10-2010
Schedule of Gasoline Diversions - Into New Jersey
SMF111
Page
of
Supplier
Supplier FID #
State Diverted From
Date
Customer
Carrier
Carrier
Terminal Product
Document
Net
Gross
Invoiced
Diversion
Customer
Mode
Shipped
FID Number
Name
FID Number
Code
Code
Number
Gallons
Gallons
Gallons
Number
Page Total
Schedule Total (report this amount on line 10, form SMF 100)
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Parent category: Financial