Free TC-110E - Utah

Schedule E -Tax Exempt Purchases
Seller' s name
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19.

Schedule is for (check one):

Motor Fuel

Account number: _________________ Month: ________________ Invoice Gross number gallons

Account name: _____________________________________________ Aviation Fuel Manifest Seller' s Transporter' s number Ship date account number name

TC-110E Rev. 6/94

Net gallons

Provide a total for each separate seller. Report both the gross gallons and net gallons on this schedule. Enter only the grand total gallons (gross or net) you chose as 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 Tax Commission.

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