Form Or-1 - Uniform Oil Response And Prevention Fee Page 2

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Schedule A. Receipts of Petroleum Products at a Marine Terminal
Within Massachusetts
Name of Massachusetts
Type of
Number
Date received
Name of vessel
Origin of product
terminal shipped to
product
of barrels
1 1 Total (enter on page 1, line 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Schedule B. Exempt Transactions of Petroleum Products
Intrastate
Type of
Number
Date received
Name and address of recipient
transfer exemption
product
of barrels
2 Total intrastate transfer exemption (enter on page 1, line 11). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Type of
Number
Date received
Name and address of recipient
F.T.Z. exemption
product
of barrels
3 Total F.T.Z. exemption (enter on page 1, line 12). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Total exemptions. Add lines 2 and 3 (enter on page 1, line 13) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
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