Form EIA-14 Refiners' Monthly Cost Report

OMB No. 1905-0174
Expiration Date:

Version No:

FORM EIA-14
REFINERS' MONTHLY COST REPORT
This report is mandatory under Public Law 93-275. Failure to comply may result in criminal fines, civil penalties and other sanctions as provided by
law. Title 18 USC 1001 makes it a criminal offense for any person knowingly and willingly to make to any Agency or Department of the
United States any false, fictitious, or fraudulent statements as to any matter within its jurisdiction. See Instructions for further details on the
sanctions and the provisions concerning the confidentiality of information submitted on this form.

PART I. RESPONDENT IDENTIFICATION
Mo

If any Respondent Identification information has changed
since the last report, enter an "X" in the block:

Year

Report Period:
EIA ID NUMBER:

Due Date: A completed form must be
filed by the 30th calendar day following
the end of the report month.

Company Name:
Physical Address:
(eg. Street Address, Bldg, Floor, Suite)
Mailing Address:
(eg. PO Box, RR)
City:

How to Submit Forms:

Zip Code

State:

-

Secure File Transfer option available at:
https://signon.eia.doe.gov/upload/noticeoog.jsp

Contact Name:
Phone No.:
Fax No.:

-

Electronic Transmission: The PC Electronic
Data Reporting Option (PEDRO) is available.
If interested in software, call (202) 586-9659.
Email form to: [email protected]
Fax form to: (202) 586-9772
Mail form to: Oil & Gas Survey
U.S. Department of Energy
Ben Franklin Station
PO Box 279
Washington, DC 20044-0279

Ext:

-

E:mail address:
Mo

Day

Year

Date of this Report:
Type of Report (Check One):
(1)
Original
(2)
Revision to Report

Mo

Day

Year

Questions? Call toll free: 1-800-638-8812

PART II. SUMMARY OF CRUDE OIL COSTS AND VOLUMES
MONTHLY ACQUISTIONS
Domestic Crude Oil
Imported Crude Oil
Category Description
Total Cost
Total Volume
Total Cost
Total Volume
PAD DISTRICT
PADD 1
PADD 2
PADD 3
PADD 4
PADD 5
Other
Total U.S.

(Thousands of dollars)

(Thousands of barrels)

(Thousands of dollars)

(Thousands of barrels)

(a)

(b)

(a)

(b)

Comments: (Unusual occurrences which may explain variations in the data and/or explanation of "Other".)