Form L-2102 - Supplier Schedule Of State Diversion Corrections

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STATE OF SOUTH CAROLINA
1350
DEPARTMENT OF REVENUE
L-2102
SUPPLIER SCHEDULE
(Rev. 10/19/11)
OF STATE DIVERSION CORRECTIONS
4190
Supplier Name
License Number
FEIN
Month/Year
PRODUCT TYPE (CIRCLE ONE AND ENTER % WHEN APPLICABLE)
Schedule II
065
Gasoline
072
Dyed Kerosene
D00
Dyed Biodiesel (100%)
122
Blend Components
130
Jet Fuel
B01-B99
Undyed Biodiesel
125
Aviation Gasoline
142
Kerosene
Blend (%
)
E00
Fuel Grade Ethanol (100%)
167
Low Sulfur Undyed Diesel
D01-D99
Dyed Biodiesel
E01-E99
Gasohol (%
)
226
High Sulfur Dyed Diesel
Blend (%
)
227
Low Sulfur Dyed Diesel
092
Other/Substitute
B00
Undyed Biodiesel (100%)
Fuel (
)
1
2
3
4
5
6
7
8
9
10
11
12
13
Carrier
Carrier
Diversion
Terminal
Original
Revised
Purchaser
Purchaser
Date
Document
Net
Gross
Billed
Name
FEIN
Number
Code
Dest St
Dest St
Name
FEIN
Shipped
Number
Gallons
Gallons
Gallons

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