Fillable F720to Form 720-TO (Rev. September 2010)

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F720to Form 720-TO (Rev. September 2010)

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The F720to Form 720-TO (Rev. September 2010) form is 3 pages long and contains:

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Form
Terminal Operator Report
OMB No. 1545-1734
(Rev. September 2010)
Department of the Treasury
Internal Revenue Service
For the month ending , 20 .
Employer identification number (EIN)
Company name
Address (number, street, room or suite number)
Terminal
Beginning inventory.
Form 720-TO (Rev. 9-2010)
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
1
Cat. No. 73072W
720-TO
Part III
Part I
Part II
City, state, and ZIP code
Contact person
Terminal Operator
Name of terminal
Terminal location
Transactions for the Month
Form 637 registration number
Email address
Terminal control number (TCN)
2
Total gallons available. Add lines 1
and 2.
3
Total disbursements. Enter the
total net gallons from Schedule(s) B,
column (f). If you have
disbursements for more than one
position holder for a PC, add the
amounts from each position holder’s
Schedule B and enter the combined
total by PC.
4
Subtract line 4 from line 3.
5
Stock gains and losses. Show
losses in (parentheses).
6
Actual physical ending inventory at
terminal.
7
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my
knowledge and belief, it is true, correct, and complete.
Signature
©
Title, if applicable
©
Date
©
Enter the transactions for the period on Schedules A and B, then complete lines
1 through 7 for each product code (PC) (see the instructions).
Fax number
Daytime telephone number
( )
( )
Net Gallons (attach additional schedule(s) if needed)
(a)
PC:
(b)
PC:
(c)
PC:
(d)
PC:
Type or print your name below signature.
Corrected
Void
Total receipts. Enter the total net
gallons from Schedule(s) A, column
(g), by PC.
Form 720-TO (Rev. 9-2010)
Product Code (PC). Enter the PC (see instructions). A separate
schedule is required for each PC
©
Terminal operator name as shown on Form 720-TO
(a)
Carrier
name
(b)
Carrier
EIN
(c)
Mode
code
(d)
Vessel official number
(required when mode code is
B, S, IB, IS, EB, or ES)
(e)
Document
date
(f)
Document
number
Page 2
For the month ending (enter MM/DD/YYYY)
TCN
EIN
Total. Add amounts in column (g) and enter the total. If there is more than one page for a PC, add the amounts from each page
and enter the result on the last page of Schedule A for that PC. Do not enter page subtotals. Enter the amount from column (g) on
Form 720-TO, Part III, line 2, in the column for the applicable PC
©
Terminal Operator Receipts
Schedule A
Form 720-TO (Rev. 9-2010)
Corrected
Void
Page
For more than one Schedule A, for each different PC, number each sheet. For
example, 1 of 4, 2 of 4, etc.
of
Enter in the columns below the information requested for the PC on line 1 above.
Position Holder (PH) name. Enter PH name for PCs Bxx, Dxx,
and Exx. Enter one name per page.
PH EIN
PH Form 637 registration number
(g)
Net
gallons
1
1a
2
3
3
Form 720-TO (Rev. 9-2010)
Terminal operator name as shown on Form 720-TO
(a)
Carrier
name
(b)
Carrier
EIN
(c)
Vessel official number
(required when mode code is
B, S, IB, IS, EB, or ES)
(d)
Document
date
(e)
Document
number
(f)
Net
gallons
Page 3
For the month ending (enter MM/DD/YYYY)
TCN
EIN
Totals. Add all amounts in columns (f) and (g) for each PC, DS, or MC. If there are two MCs for a product destined for one
state, or if a product is destined for two states, then two Schedules B and totals are required. If there is more than one Schedule
B for a PC, DS, or MC, add the amounts from each schedule and enter the result on the last page of Schedule B for each
different PC, DS, or MC. Do not enter page subtotals. Enter the amount from column (f) for each PC on Form 720-TO, Part III,
line 4, in the column for the applicable PC
©
Terminal Operator Disbursements by Position Holder
Schedule B
Form 720-TO (Rev. 9-2010)
Corrected
Void
Page
For more than one Schedule B, for each different PC, DS, or
MC, number each sheet. For example, 1 of 4, 2 of 4, etc.
of
Enter in the columns below the information requested for the PC on line 1 above.
Position Holder name. Enter one name per page.
PH EIN
PH Form 637 registration number
(g)
Gross
gallons
Complete lines 1 through 4 for each PC.
Product Code (PC). Enter the PC (see instructions). A separate schedule is required for each PC
©
Destination State (DS). Enter the DS for each PC (see instructions). A separate schedule is required for each PC by state. PC 167 destined for Virginia
(VA) and Maryland (MD) requires two schedules
©
Mode Code (MC). Enter the MC (see instructions) for each PC for each DS. PC 167 destined for VA by truck and rail and destined for MD by truck and
rail would require four separate schedules: (1) PC 167, VA, rail; (2) PC 167, VA, truck; (3) PC 167, MD, rail; and (4) PC 167, MD, truck
©
Example. ABC Terminal is preparing Schedule B for disbursements made by position holder XYZ. XYZ disburses gasoline (PC 065), diesel fuel #2 low sulphur undyed
(PC 167), and jet fuel (PC 130) during the month destined for two states by truck. ABC must prepare six Schedules B to report XYZ’s transactions (3 PCs x 2 DSs). A
further breakdown by MC is not needed because only truck was used.
5(f)
5(g)
1
2
3
4
5
1
2
3
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F720to Form 720-TO (Rev. September 2010)

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Completed 4 June 2020

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