Free TC110D1 - Utah

Schedule is for Aviation Fuel Only

Account number: Account name: Month:

TC-110J Rev. 6/94

Seller's name and account number
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19.

Ship date

Seller's ivoice number

Gross gallons

Net gallons

Report both the gross gallons and net gallons on this schedule. Enter only the total gallons ( gross or net ) you chose as your elected reporting basis to TC-109A. Attach this schedule to form TC-109A and file with the Utah State T ax Commission.

CONVERSION OF JET FUEL TO NON-A

VIATION USE MA Y BE SUBJECT TO SALES T AX OR 19 ¢ EXCISE T AX.

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

Clear form

Print Form
TC-110J.CDR