Form Wv/mft-508d - Importer Schedule Of Diversions Into West Virginia - 2003
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2WV/MFT-508 D
WEST VIRGINIA STATE TAX DEPARTMENT
Org. (5/03)
INTERNAL AUDITING DIVISION
P O BOX 2991
Charleston, WV 25330-2991
(304) 558-8500
IMPORTER SCHEDULE OF DIVERSIONS INTO WEST VIRGINIA
FEIN/SSN
NAME
SCHEDULE NUMBER
MONTH/YEAR
11
PRODUCT INFORMATION (CHECK APPLICABLE BOX)
MODE OF TRANSPORTATION
(COMPLETE SEPARATE SCHEDULES FOR EACH PRODUCT TYPE YOU DIVERT)
CODES
□ 150 – #1 Fuel Oil
□ 228 – Diesel – Dyed
□ 054 – Propane
J – Truck
□ 125 – Aviation Gasoline
□ 160 – Diesel – Undyed
□ 224 – Compressed Natural Gas
R – Rail
□ 130 – Aviation Jet Fuel
□ 284 – Biodiesel – Undyed
□ 225 – Liquefied Natural Gas
□ 122 – Blending Components
□ 072 – Kerosene – Dyed
□ Other – Product Type ___________
□ 124 – Gasohol
□ 142 – Kerosene – Undyed
Product Code __________
□ 065 – Gasoline
PRODUCT RECEIPT INFORMATION
(1)
(2)
(3)
(4)
(5)
(7)
(8)
(9)
(10)
(11)
(12)
(6)
Mode
Point of
Date
Document
Gross
Net
INVOICED
Diversion
Motor Fuel
Motor Fuel
Purchaser’s
Purchaser’s
Received
Number
Gallons
Gallons
GALLONS
Number
Transporter’s
Transporter’s
Origin
Destination
Name
FEIN/SSN
Name
FEIN/SSN
Sub Total
–
GRAND TOTAL OF INVOICED GALLONS
Transfer to Line 2 and 4 (by fuel type) of Report
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