Form Omf-11 Draft - Terminal Operator Report Page 2
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4Division use only — DLN Stamp
Month
Year
Pursuant to NJSA 54:39-101 et seq
10-2010
OMF-101
Schedule of Terminal Operator Receipts
Form must be completed listing each Position Holder in numerical order by FID#. A separate form is required for each product.
Products reported should include all products maintained in the terminal. For a list of product codes refer to the FTA product code list.
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of
Taxpayer
Taxpayer ID #
Position Holder
Date
Document
Product
FID#
Position Holder
Received
Number
Net Gallons
Gross Gallons
Code
Mode
Carrier FID#
Carrier
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