Form The STB has not as The STB has not as Report of Fuel Cost, Consumption, and Surcharge Revenue

OMB Control No. 2140-XXXX
Expires _____________, 2010

RAILROAD NAME ____________________
MONTHLY REPORT OF
FUEL COST, CONSUMPTION, AND SURCHARGE REVENUE
FOR THE MONTH OF _________, 20__
Instructions: The report shall contain data only for the reported month. Cost and
revenue are defined as accrued or earned that month. The report shall be filed with the
Surface Transportation Board on or before 20 days after the end of that month.

LI N E
NO

Data

Amount

(a)

(in thousands)
(b)

1

Total fuel cost 1

2

Gallons of fuel consumed1

3

Increased or decreased cost of fuel 2

4

Revenue from fuel surcharges 3

I, the undersigned, _______________, Title: _______, state that this report was
prepared by me or under my supervision and that I have carefully examined it and on the
basis of my knowledge, belief, and verification declare it to be full, true and correct.
______________________________

1

Include fuel for freight, yard and work train locomotives. Include fuel charged
to train and yard service (function 67-Locomotive Fuels). Include all other fuel used for
railroad operations and maintenance, including motor vehicles and power equipment not
charged to function 67- Locomotive Fuels.
2

Show the total increase or decrease in fuel cost over previous month.

3

Show the total revenue collected from fuel surcharges.