Form Pda-78 - Petroleum Product Reconciliation

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PDA-78
Petroleum Product Reconciliation
Tax Paid Purchases
Gallons Received
Purchase
Supplier’s
Supplier’s Minnesota
Gasoline
Undyed Fuel
Dyed Fuel
Date
Name
Tax ID Number
Oil
Oil
Totals (enter on line 2 below)
Product Reconciliation
Gasoline
Undyed Fuel oil
Dyed Fuel Oil
1 Total gallons reported on monthly gasoline tax return . . . . . . . . . . . . . . . . . . . . .
2 Tax paid purchases (enter totals from above) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 Total of all receipts (add lines 1 and 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 First-of-month inventory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 Total to account for (add lines 3 and 4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Sales and company use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7 End-of-month book inventory (subtract line 6 from line 5) . . . . . . . . . . . . . . . . . .
8 End-of-month measured readings (see worksheet below) . . . . . . . . . . . . . . . . . . .
9 Loss or gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Worksheet for line 9
Gasoline
Undyed Fuel Oil
Dyed Fuel Oil
ft
in . . . . . .
A Gasoline . . . . . . . . . . . . . . . . . . . . . . . .
B Number 1 fuel . . . . . . . . . . . . . . . . . . .
ft
in . . . . . .
ft
in . . . . . .
C Number 2 fuel . . . . . . . . . . . . . . . . . . .
ft
in . . . . . .
D Kerosene . . . . . . . . . . . . . . . . . . . . . . .
E Other . . . . . . . . . . . . . . . . . . . . . . . . . .
ft
in . . . . . .
F In tank wagons (gallons)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
G Total (enter on line 8 above) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Keep this form for future audits.
Website: Email: Petroleum.Tax@state.mn.us. Phone: 651-296-0889.
(Rev. 8/17)

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