Form Sft-3 - Supplier'S Tax Return - Special Fuels Page 2

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Inventories and Receipts.

Do not include liquified gases. Use separate Schedule LG.

Gallons (use whole gallons only)

11 Inventory on hand, first of month (Attach explanation if different

from. . . . . . . . . . . . . . . . . . . . . . . .

prior month closing inventory) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

12 Gallons purchased (Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

13 Total gallons. Add lines 1 and 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

14 Actual inventory on hand, end of month (from stick reading) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

15 Total gallons to be accounted for. Subtract line 4 from line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Disposition

16 Taxable gallons placed or used in own or leased registered motor vehicles

(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

17 Taxable gallons sold to other users (Schedule C). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

18 Taxable gallons sold to user-sellers (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

19 Total taxable gallons. Add lines 6 through 8. Enter here and on page 1, line 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 319

10 Nontaxable gallons sold or used in nonregistered equipment (Schedule E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 310

11 Total gallons. Add lines 9 and 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Type of Special Fuel

Column A

Column B

Note: The following amounts should be taken from the schedule noted below.

Gross costs*

Gallons

12 Diesel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 312

13 Propane (from Schedule LG, line 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313

14 Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 314

15 Totals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315

*Gross costs, for purposes of column A above, means the total amount, exclusive of U.S. and Massachusetts fuel taxes, paid by you as consideration of

fuel used by you and not resold, for purchases valued in money or otherwise, including any amounts for which credit was given to you and any fuel trans-

portation cost to you.

Records to substantiate the above costs and gallonage computations must be retained for audit.

Schedule A. Bulk Purchases.

List each transaction separately. Do not include liquified gases. Use separate Schedule LG.

In state

Dates

Gallons purchased

Point of origin

Names of suppliers

purchased

this month

Out of state