Schedule B -Tax Paid Purchases
Schedule is for (check one):
Motor Fuel Aviation Fuel
Account number: _________________ Account name: ________________________________________ Month: _____________
TC-110B Rev. 9/02
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.
Manifest number
Ship date
Seller's invoice number
Gross gallons
Net gallons
Destination
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 on 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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