Form Pet 382 - Schedule Of Diversion Corrections - Distributor Fuel Tax Return (Attach To Pet 350)

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Schedule of Diversion Corrections - Distributor Fuel Tax Return (Attach to PET 350)
PET
Company Name:
FEIN:
Account Number:
Month of (MM-YY):
382
Tennessee Department of Revenue
Product Type (Circle One)
65 GASOLINE
142 KEROSENE
122 BLENDING COMPONENTS (TRANSMIX)
160 UNDYED DIESEL
SCHEDULE TYPE 11
123 ALCOHOL
226 DIESEL (HIGH SULFER DYED)
124 GASOHOL
227 DIESEL (LOW SULFER DYED)
125 AVIATION GASOLINE
____ OTHER (SEE ITA PRODUCT CODE LIST)
130 JET FUEL
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
( 1 1 )
(12)
(13)
ORIGINAL
R E V I S E D
CARRIER
CARRIER
DESTINATION
DESTINATION
TERMINAL
PURCHASER
PURCHASER
DATE
DOCUMENT
NET
GROSS
B I L L E D
DIVERSION
NAME
FEIN
MODE
STATE
STATE
CODE
NAME
FEIN
S H I P P E D
NUMBER
GALLONS
GALLONS
GALLONS
NUMBER
RV-R0010201

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