Free TC110A - Utah

by non-Utah licensed distributor

Schedule is for (check one)

Motor Fuel Aviation Fuel

Account number: Account name: Month: TC-110D2 Rev. 6/94

Name of non-li censed customer

Date cl aim was received

Sel ler's invoi ce number

Gross gall ons

Net gal lons

List each state's exports on a separate TC-110D2. Report both the gross gallons and net gallons on this schedule. Enter only the grand total gallons (gross or net) you chose your elected reporting basis to TC-109 or TC-109A. Attach this schedule to form TC-109 or TC-109A and file with the Utah State T ax Commission.

IMPORTANT: To protect your privacy, use the "Clear form" button when you are finished.

Clear form

Print Form
TC-110D2.CDR