(a) The date the fuel is withdrawn.
(b) The number of gallons.
(c) The fuel type.
(d) The company unit number, or the motor vehicle license plate number and state.
(a) The date of sale.
(b) The name and station address of the vendor (printed or with credit card imprint).
(c) The name and address of the purchaser or permittee.
(d) The number of gallons sold.
(e) The signature of the purchaser.
(f) The company unit number, or the motor vehicle license plate number and state.
(a) The date the fuel was withdrawn from the bulk storage facility.
(b) The number of gallons.
(c) The fuel type.
(d) The company unit number, or the motor vehicle license plate number and state.
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