Form 72A154-S "Supplier's Report - Special Fuels Imported (Kentucky Tax Paid by Supplier)" - Kentucky

What Is Form 72A154-S?

This is a legal form that was released by the Kentucky Department of Revenue - a government authority operating within Kentucky. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2006;
  • The latest edition provided by the Kentucky Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form 72A154-S by clicking the link below or browse more documents and templates provided by the Kentucky Department of Revenue.

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Download Form 72A154-S "Supplier's Report - Special Fuels Imported (Kentucky Tax Paid by Supplier)" - Kentucky

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72A154-S (10-06)
SUPPLIER’S REPORT
Commonwealth of Kentucky
SPECIAL FUELS IMPORTED
FILE IN DUPLICATE
DEPARTMENT OF REVENUE
(KENTUCKY TAX PAID BY SUPPLIER)
Name and Address of Dealer
Instructions: Complete this report by listing all special fuels sold at the
terminal rack for import into Kentucky and on which you charged the
Report for
Kentucky special fuels excise tax to your customer. Use a separate line
for each shipment. File a separate form for each purchaser and each
___ / ___
state providing the total gallons sold. Submit this form in duplicate.
Attach to Form 72A138.
KY Special
Name and Address
Carrier
Origin
Destination (City
Bill of Lading
Date of
Fuels Dealer
Carrier Name
Invoice Number
Gallons
of Customer
Number
(City and State)
in Kentucky)
Number
Shipment
License No.
TOTAL*
*Total gallons must equal Line 2a, Form 72A138.
72A154-S (10-06)
SUPPLIER’S REPORT
Commonwealth of Kentucky
SPECIAL FUELS IMPORTED
FILE IN DUPLICATE
DEPARTMENT OF REVENUE
(KENTUCKY TAX PAID BY SUPPLIER)
Name and Address of Dealer
Instructions: Complete this report by listing all special fuels sold at the
terminal rack for import into Kentucky and on which you charged the
Report for
Kentucky special fuels excise tax to your customer. Use a separate line
for each shipment. File a separate form for each purchaser and each
___ / ___
state providing the total gallons sold. Submit this form in duplicate.
Attach to Form 72A138.
KY Special
Name and Address
Carrier
Origin
Destination (City
Bill of Lading
Date of
Fuels Dealer
Carrier Name
Invoice Number
Gallons
of Customer
Number
(City and State)
in Kentucky)
Number
Shipment
License No.
TOTAL*
*Total gallons must equal Line 2a, Form 72A138.