Form Pt-101.2 - Transfers And Sales Of Motor Fuel Outside New York State

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PT-101.2
New York State Department of Taxation and Finance
Transfers and Sales of Motor Fuel Outside New York State
(9/06)
Read instructions (Form PT-101-I) carefully. Keep a copy of this completed form for your records.
Name of distributor
FEIN
Month/year
Submit in duplicate. Use a separate sheet for each state and province. To the state or province of:
Part 1 — Transfers and sales out of New York State
Date
Mode of
Carrier’s name
Customer’s name
Origin
Destination
Manifest
Gallons
Product
shipped
delivery
and FEIN
and FEIN
terminal control
terminal control
number
code*
or sold
number or
number or
(city, state)
(city, state)
Total gallons
...........................................................................................................................................................................
(enter here and on Form PT-101, line 9)
*From Publication 902, Product Codes for Fuels.

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