Form 06-183 - Amended Schedule Of Gallons Exported
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1
206-183
-- AMENDED --
(Rev.3-06/3)
b.
PRINT
<choose one>
a.
DO NOT WRITE IN SHADED AREAS
TYPE or PRINT
TEXAS SCHEDULE OF
c. Taxpayer number
d. Filing period
GALLONS EXPORTED
(Item 15)
f.
e. Taxpayer name
1. Transporter name
2. Transporter taxpayer number
LOCATOR NUMBER
3. Seller name
4. Seller taxpayer number
5. Product type
6. Mode
7. Destination
8. Date removed
9. Shipping doc. no.
10. Terminal control number
11. Invoiced gallons
12. Were these gallons
13. Bulk plant name and physical address
purchased tax-paid?
1 =YES 0 =NO
LOCATOR NUMBER
1. Transporter name
2. Transporter taxpayer number
3. Seller name
4. Seller taxpayer number
5. Product type
6. Mode
7. Destination
8. Date removed
9. Shipping doc. no.
10. Terminal control number
11. Invoiced gallons
12. Were these gallons
13. Bulk plant name and physical address
purchased tax-paid?
1 =YES 0 =NO
1. Transporter name
2. Transporter taxpayer number
LOCATOR NUMBER
3. Seller name
4. Seller taxpayer number
5. Product type
6. Mode
7. Destination
8. Date removed
9. Shipping doc. no.
10. Terminal control number
11. Invoiced gallons
12. Were these gallons
13. Bulk plant name and physical address
purchased tax-paid?
1 =YES 0 =NO
1. Transporter name
2. Transporter taxpayer number
LOCATOR NUMBER
3. Seller name
4. Seller taxpayer number
5. Product type
6. Mode
7. Destination
8. Date removed
9. Shipping doc. no.
10. Terminal control number
11. Invoiced gallons
12. Were these gallons
13. Bulk plant name and physical address
purchased tax-paid?
1 =YES 0 =NO
1. Transporter name
2. Transporter taxpayer number
LOCATOR NUMBER
3. Seller name
4. Seller taxpayer number
5. Product type
6. Mode
7. Destination
8. Date removed
9. Shipping doc. no.
10. Terminal control number
11. Invoiced gallons
12. Were these gallons
13. Bulk plant name and physical address
purchased tax-paid?
1 =YES 0 =NO
LOCATOR NUMBER
1. Transporter name
2. Transporter taxpayer number
3. Seller name
4. Seller taxpayer number
5. Product type
6. Mode
7. Destination
8. Date removed
9. Shipping doc. no.
10. Terminal control number
11. Invoiced gallons
12. Were these gallons
13. Bulk plant name and physical address
purchased tax-paid?
1 =YES 0 =NO
TOTAL INVOICED GALLONS
(Sum of Item 11)
FOR THIS PAGE ONLY
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