Form Tc-110e - Schedule E - Tax Exempt Purchases
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1Account number: _________________
Schedule is for
TC-110E
Motor Fuel
(check one):
Account name:
Month: ________________
Rev. 6/94
Aviati on Fuel
Transporter's
Manifest
Invoice
Gross
Net
Seller's
Sel ler's name
Account number
name
number
Ship date
number
gal lons
gal lons
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Provi de a total for each separate sel
ler. Report both the gross gall ons and net gallons on this schedul
e. Enter onl y the grand
total gallons (gross or net) you chose as your elected reporting basis to TC-109 or TC-109A. Attach this schedul
e to form
TC-109 or TC-109A and fil e with the Utah State T ax Commission.
TC-110E.CDR
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