Form 06-134 - Texas Schedule Of Motor Fuel Transporter Deliveries - 2002 Page 2
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2Form 06-134(Back)(Rev.9-03/2)
TEXAS SCHEDULE OF MOTOR FUEL TRANSPORTER DELIVERIES--EXPORTS
You have certain rights under Ch. 559, Government Code, to review, request, and correct information
we have on file about you. Contact us at the address or toll-free number listed on this form.
WHO MUST FILE
Every motor fuel transporter that transports gasoline or diesel fuel outside the bulk transfer/terminal system from Texas by truck,
railroad tank car, or marine vessel must file. Failure to file a required quarterly report may result in the assessment of civil penalty
as prescribed by Chapter 162 of the Tax Code.
FOR ASSISTANCE
For assistance with any Texas Fuels Tax questions, please contact the Texas State Comptroller's Office at 1-800-252-1383
toll-free nationwide, or call 512-463-4600. (From a Telecommunications Device for the Deaf (TDD) ONLY, call 1-800-248-4099
toll free, or call 512/463- 4621.)
GENERAL INSTRUCTIONS
Please write only in white areas.
TYPE or PRINT all information.
Complete all applicable items that are not preprinted.
If any preprinted information is not correct, mark out the incorrect item and write in the correct information.
ROUND ALL GALLONAGE FIGURES TO WHOLE GALLONS.
SPECIFIC INSTRUCTIONS
Item 1 - Enter the name of the seller.
Item 2 - Enter the taxpayer number or FEIN of the seller of the fuel.
Item 3 - Enter the name of the purchaser.
Item 4 - Enter the 11-digit taxpayer number of the purchaser of the fuel.
Item 5- Enter the three digit product type.
065 - Gasoline
228 - Dyed diesel fuel
072 - Dyed Kerosene
125 - Aviation gasoline
124 - Gasohol
160 - Clear diesel fuel
142 - Clear kerosene
130 - Jet fuel
Item 6- Enter a valid character for mode of transportation. Use one of the following:
J - Truck
R - Rail
B - Barge
Item 7 - Enter the 2-character standard state abbreviation of the state the fuel is destined for export. For example, AR for
Arkansas. If destination is outside the United States, enter 'ZZ'.
Item 8 - Enter the date, MM/DD/YY, as it appears on the Shipping Document/Bill of Lading. This is the date the fuel was
PHYSICALLY REMOVED from a terminal or bulk plant. May be left blank if summarizing transactions. See Item 9.
Item 9 - Enter the Shipping Document/Bill of Lading number. This is the identifying number from the document issued at the
terminal or bulk plant, when the product is removed. You may report the summary of multiple transactions when the
seller, the purchaser, the product type, the terminal control number or bulk plant location address in Item 10, and the
destination state are the same. Enter the word 'SUM.' You must maintain detailed records of transactions reported
as a summary.
Item 10 - Enter the terminal control number of the facility the fuel was removed. Enter the physical street address and city of the
bulk plant when the fuel is removed from a non-IRS registered bulk plant.
Item 12 - Enter invoiced gallons, rounding to the nearest whole gallon. You may report the summary of multiple transactions
when the seller, the purchaser, the product type, the terminal control number or bulk plant location address in Item 10,
and the destination state are the same. See Item 9.
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