Form 637 Questionnaires

Name:	EIN:
Address:	Registration No:
City, State, Zip

“X” QUESTIONNAIRE (Revision 02-01-2006)

Pipeline operator or vessel operator (including certain deep-draft vessels) within the bulk transfer/terminal system..

Review Form 637, "Application for Registration" for any updates or changes. This includes Part I, II, and III. Attach the updates or changes to questionnaire. Notate if no updates or changes have been made since last visitation.

1. Does the company, related company, or any of its owners incur any liability for excise tax? If so, name the type of tax. __________________________________________________________________________________________________________________________________________

2. Does the company sell or plan to sell any taxable fuel? If so, describe the arrangements.

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

3. Has the company's excise, employment, or income tax returns been examined by the State or IRS during the previous five years? If so, what were the results of the examination?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

4. Does the company store or ship any fuel to which it holds title? If so, where is this inventory stored? For who is it stored? Are separate inventory records maintained?

_______________________________________________________________________________________________________________________________________________________________________________________________________________

5. Are you registered or required to be registered by state or local authorities? If so, list the licensing agencies and numbers and dates granted.

_______________________________________________________________________________________________________________________________________________________________________________________________________________

6. Provide the estimated annual volume of gasoline, undyed and dyed diesel fuel, and kerosene that will be shipped or imported from another country.

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

7. List all liquid products that are received from or delivered to a fuel terminal.

_______________________________________________________________________________________________________________________________________________________________________________________________________________

8. Provide a map of each pipeline that you operate with the name and address of each refinery, terminal, and transfer station served by each pipeline.

_____________________________________________________________________

9. Provide a map of each route in which the vessel operates and the name and address of each refinery and terminal served by the vessel.

_____________________________________________________________________

10. List the identifying number of all vessels you operate that transport taxable fuel (gasoline, diesel fuel and/or kerosene), and state their capacity. Attach extra sheets if necessary. Exclude deep draft ocean-going vessels.

Vessel or Barge Number	Home Port	Capacity

11. As a bulk transport carrier (barge, vessels, and pipelines), are you required to file Form 720-CS, Carrier Summary Report? If not, please explain _________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

TIN - DATE –