Terminal Operators Inventory Ownership Schedule {Schedule 501I}

State Form 49092 10-03 Schedule 501I Terminal Operator's Inventory Ownership Schedule License Number FEIN Terminal Code Month/Year Terminal Operator Name You may photocopy this blank schedule for future filings. Attach additional sheets if necessary. Product Code/Type (Check One) For Use with Reporting Special Fuel 142 Kerosene 161 Low Sulphur Diesel #1 - undyed 167 Low Sulphur Diesel #2 - undyed 226 High Sulphur Diesel - dye added 227 Low Sulphur Diesel - dye added 231 No. 1 Diesel - dye added 284 Biodiesel - undyed 290 Biodiesel - dye added OTH Other For Use with Reporting Gasoline/Oil Inspection 065 Gasoline 124 Gasohol 125 Aviation Gasoline 130 Jet Fuel Gasoline 142 Kerosene 150 #1 Fuel Oil - undyed 161 Low Sulphur Diesel #1 - undyed 231 No. 1 Diesel - dye added 241 Ethanol 243 Methanol 282 #1 High Sulphur Diesel - undyed OTH Other Position Holder (1) Name/Address (2) FEIN (3) Beginning Inventory (4) Net Gallons Received (5) Net Gallons Disbursed (6) Stock Gain/Loss (7) Ending Inventory (8) Capacity of Position Holder's Storage Space American LegalNet, Inc. www.FormsWorkflow.com Instructions for Completing Terminal Operator's Inventory Ownership Schedule Schedule 501I Before You Begin: Enter your company's identifying information as it is reflected on your Indiana Fuel Tax License. (Be certain to complete a separate schedule for each fuel product type that you circle.) Column Instructions: Columns 1 and 2: Enter the position holder's name, address, and Federal Employers Identification Number (FEIN). Column 3: Enter the position holder's actual beginning physical inventory for each particular product type. Column 4: Enter the position holder's net gallons received as subtotaled in Column 8 of the Terminal Operator's Schedule(s) of Receipts (Schedule 501A) for each particular product type. Column 5: Enter the position holder's net gallons disbursed as subtotaled in Column 9 of the Terminal Operator's Schedule(s) of Disbursements (Schedule 501B) for each particular product type. Column 6: Enter the position holder's stock gain/loss for each particular product type. American LegalNet, Inc. www.FormsWorkflow.com Column 7: Enter the position holder's actual ending physical inventory for each particular product type. Column 8: Enter each position holder's capacity of their owned/leased storage space in the terminal for the reported product type.