Form Dst - 201 - Motor Fuel Terminal Operator Monthly Report
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1
2105-32
State of Oklahoma
DST - 201
Oklahoma Tax Commission
(12/05)
Motor Fuel Terminal Operator Monthly Report
Name and Physical Address of Terminal
This report is due on the 27th of the next month
Office Use Only
Operator FEIN
Operator Name and Address
Terminal Code
Month/Year
Monthly Summary of Transactions for the Month _____________________
Undyed
Dyed
Undyed
Dyed
Blending
Aviation
Jet
Undyed
Dyed
Description
Schd
Gasoline
Diesel Fuel
Diesel Fuel
Biodiesel
Material
Gasoline
Fuel
Kerosene
Kerosene
Biodiesel
E85
1
Beginning Inventory
15C
15A
2
Total Receipts
3
Total Gallons Available for Removal
CALC
15B
4
Undyed Diesel Fuel Disbursements
15B
5
Undyed Biodiesel Fuel Disbursements
15B
6
Undyed Kerosene Disbursements
15B
7
Other Fuel Disbursements
CALC
8
Gallons Available (Less Disbursements)
CALC
9
Gain/Loss (Inventory Adjustment)
15C
10
Actual Ending Inventory
I/We declare under the penalties of perjury that this return including any accompanying schedules and statements has been examined by me/us and to the best of my/our knowledge and belief is a true, correct and
complete return made in good faith for the taxable period stated, pursuant to any existing laws requiring the filing of this return.
Date
Signed
By
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