Form Mft-18 - Fuel Carrier Questionnaire Page 2
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214. List the names and addresses of all persons for whom fuel is transported, also list products transported. (Attach rider, if necessary).
Name and Address
Products
______________________________________________________________
__________________________________________
______________________________________________________________
__________________________________________
______________________________________________________________
__________________________________________
______________________________________________________________
__________________________________________
15. List below the products picked up in other states to be delivered to a New Jersey location. (Attach rider, if necessary).
State
Products
______________________________________________________________
__________________________________________
______________________________________________________________
__________________________________________
______________________________________________________________
__________________________________________
______________________________________________________________
__________________________________________
16. Does your firm lease tanks to other firms or individuals? . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
What is the least amount of time a tanker can be leased? . . . . . . . . . . . . . . . . . . . . . . . . ___________________________________________
17. List below the Transporter License numbers for all vehicles or vessels maintained and operated by your firm. (Attach rider, if necessary).
Truck Number
Transporter
Operated By
Vessel Name
License Number
Gas
Diesel
Other
17a. Number of Tractors maintained ___________________________________
Tank Trailers _______________________________________
18. Do you maintain bulk storage of fuel for your business?
Yes
No
Size of tank(s)_______________________________________ gallons.
Type of fuel:
Gasoline
Diesel
Other __________________________________________________________
If you store Diesel, list your MFT Seller/User License No:
__________________________________________________________________
19. List below your supplier(s) of the above stated fuels for the past two years. (Attach rider, if necessary).
Fuel Type
Supplier (Name & Address)
20. Give name, title, address and telephone number of person charged with the duty of filing Motor Fuel tax reports and location where reports are
prepared and records kept.
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
21. Person completing this questionnaire: ____________________________________________________(__________)__________- _____________
(Print or Type)
(Telephone Number)
_______________________________________________________________________________________________________________________
(Signature)
(Title)
(Date)
18:18-8.1 Reports by Fuel Carriers
Every railway or railroad company, water transportation company, and person transporting fuels as herein defined, in bulk, between points within the State, and every
water transportation company and person transporting fuel in bulk to a point outside the State from any point within the State, must at any time, upon written request of the
Director, report, in a manner prescribed by the Director, all deliveries of fuel so made to points within or without the State.
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