EIA-878 Motor Gasoline Price Survey

U. S. DEPARTMENT OF ENERGY
ENERGY INFORMATION ADMINISTRATION
Washington, D.C. 20585

Form Approved
OMB Number: 1905-0174
Expiration Date:

EIA-878:
MOTOR GASOLINE PRICE SURVEY
This report is mandatory under the Federal Energy Administration Act of 1974 (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. IDENTIFICATION DATA
Company Name

Name of Contact Person

Contact’s Telephone Number
City

State

Zip Code

Prices for:
Month

DOE ID No.

PART II. PRICE DATA
(Enter the retail price of self-service, cash only, gasoline for each grade, including all taxes)

Grade

Regular

Midgrade

Premium

Comments:

Price
($0.000 per gallon)

Day

Year