Form Wv/mft-508b - Importer Schedule Of Tax-Unpaid Receipts - 2003
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2WV/MFT-508 B
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 TAX-UNPAID RECEIPTS
FEIN/SSN
NAME
SCHEDULE NUMBER
MONTH/YEAR
2
PRODUCT INFORMATION (CHECK APPLICABLE BOX)
MODE OF TRANSPORTATION
(COMPLETE SEPARATE SCHEDULES FOR EACH PRODUCT TYPE YOU RECEIVE)
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
Import
Motor Fuel
Motor Fuel
Seller’s Name
Seller’s
Received
Number
Gallons
Gallons
GALLONS
Confirmation
Transporter’s
Transporter’s
Origin
Destination
FEIN/SSN
Number
Name
FEIN/SSN
Sub Total
–
GRAND TOTAL OF INVOICED GALLONS
Transfer to Line 1 of Report
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Parent category: Financial