Form Gas-1219ds - Motor Fuel Importer Schedule Of Disbursements - 2004
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1Motor Fuel Importer Schedule of Disbursements
File with GAS-1219
Gas-1219DS
Web
North Carolina Department of Revenue
1-04
Schedule
Product
Legal Name (First 35 Characters) (USE CAPITAL LETTERS FOR YOUR NAME)
Account Number
Type
Type
Month
Year
-
Schedule Type
Mode (Column 3)
Product Type
J
=
5A
Gallons sold to retailers, bulk-end users, unlicensed distributors, and company-owned stations
Truck
065 Gasoline
142 Kerosene - Undyed
R
=
Dyed diesel or dyed kerosene gallons sold for taxable purposes
Rail
5F
072 Kerosene - Dyed
160 Diesel - Undyed
B
=
Barge
Dyed diesel or dyed kerosene gallons sold for exempt purposes
122 Blending Components
226 Diesel - High Sulfur Dyed
6F
PL
=
Pipeline
7
Gallons sold for export to state of ____________
123 Alcohol
227 Diesel - Low Sulfur Dyed
=
S
Ship
124 Gasohol
241 Ethanol
8
Gallons sold to the U.S. Government
=
B A
Book Adjustment
125 Aviation Gasoline
243 Methanol
9A
Gallons sold to the State of North Carolina
=
ST
Stationary Transfer
130 Jet Fuel
284 Biodiesel - Undyed
9C
Gallons sold to a N.C. local board of education
=
CE
Summary
290 Biodiesel - Dyed
Gallons sold to a N.C. county or municipal corporation
9E
Gallons sold to a N.C. charter school
9F
9G
Gallons sold to a N.C. community college
(1)
(2)
(3)
(4)
(6)
(7)
(8)
(9)
(12)
Carrier
Carrier
Point of
Purchaser
Purchaser
Date
Document
Billed
Mode
Name
FEIN
Destination
Name
FEIN
Shipped
Number
Gallons
TOTAL
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