Form L-2103 - Supplier Schedule Of Terminal Rack Removals

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STATE OF SOUTH CAROLINA
1350
DEPARTMENT OF REVENUE
L-2103
SUPPLIER SCHEDULE
(Rev. 10/19/11)
OF TERMINAL RACK REMOVALS
4191
Supplier Name
License Number
FEIN
Month/Year
SCHEDULE TYPE (CIRCLE ONE)
5-A
Gallons Removed Subject to User Fee
7-A
Gallons Removed for Export to
by Supplier
(Non-eligible Purchaser)
(Dest State Tax Collected)
5-C
Gallons Removed Subject to User Fee
7-B
Gallons Removed for Export to
by Supplier
(Eligible Purchaser)
(Dest State Tax Exempt)
5-E
Gallons Removed User Fee Paid for Import by Importer
8
Gallons Removed for US Government Sales
5-H
Gallons Removed User Fee Paid - For Export by Licensed Exporter
9-C
Gallons Removed for SC Department of Education School Buses
6-F
Gallons Removed - Dyed Fuel
10-B
Gallons Removed for Aviation Use
6-H
Gallons Removed User Fee Free Import by Licensed Importer
10-G
Gallons Removed for Other Exempt Sales
PRODUCT TYPE (CIRCLE ONE AND ENTER % WHEN APPLICABLE)
065
Gasoline
072
Dyed Kerosene
D00
Dyed Biodiesel (100%)
122
Blend Components
130
Jet Fuel
B01-B99
Undyed Biodiesel
125
Aviation Gasoline
142
Kerosene
Blend (%
)
E00
Fuel Grade Ethanol (100%)
167
Low Sulfur Undyed Diesel
D01-D99
Dyed Biodiesel
E01-E99
Gasohol (%
)
226
High Sulfur Dyed Diesel
Blend (%
)
227
Low Sulfur Dyed Diesel
092
Other/Substitute
B00
Undyed Biodiesel (100%)
Fuel (
)
1
2
3
4
5
6
7
8
9
10
11
12
Carrier
Carrier
Point Of
Terminal
Purchaser
Purchaser
Date
Document
Net
Gross
Billed
Name
FEIN
Mode
Destination
Code
Sold To
FEIN
Shipped
Number
Gallons
Gallons
Gallons

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