Form Tc-110b - Schedule B - Tax Paid Purchases

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Account number: _________________
Schedule is for
Motor Fuel
Schedule B -Tax Paid Purchases
TC-110B
(check one):
Rev. 9/02
Aviation Fuel
Account name: ________________________________________
Month: _____________
Manifest
Seller's invoice
Gross
Net
Ship date
Destination
Seller's name and account number
number
number
gallons
gallons
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2.
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Report both the gross gallons and net gallons on this schedule. Enter only the total gallons
(gross or net)
you chose as your elected reporting
basis on TC-109 or TC-109A. Attach this schedule to form TC-109 or TC-109A and file with the Utah State Tax Commission.
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