Form 72a159 - Report Of Special Fuels Sold For Exclusive Use By Railroad Companies For Nonhighway Purposes - Kentucky Department Of Revenue

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72A159 (10-06)
REPORT OF SPECIAL FUELS SOLD FOR EXCLUSIVE USE
Commonwealth of Kentucky
DEPARTMENT OF REVENUE
BY RAILROAD COMPANIES FOR NONHIGHWAY PURPOSES
INSTRUCTIONS: This form must be filed by dealers claiming
a deduction for special fuels sold to railroad companies for
For Month of _______________________ , 20____
Dealer License Number ______________________________________
nonhighway purposes. All information on this form must be
completed.
Purchaser’s Kentucky
Invoice
Invoice
Quantity Sold
Motor Fuels Tax
Purchaser’s Name
Street Address
City
ZIP Code
Number
Date
(Gallons)
Refund Permit Number
(Attach continuation sheets if needed.)
TOTAL (to line 9, Form 72A138)

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