IMPORTER/ENTERER
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Identify
the name and address of suppliers of taxable fuel, type of
taxable fuel imported, quantity imported, and the origin of the
imported taxable fuel.
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Supplier’s
Name and Address
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Taxable
Fuel Imported
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Quantity
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Origin
of Imported Taxable Fuel
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Identify
the ports of entry and location of the imported taxable fuel.
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Ports of Entry
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Location of Port
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Identify
the carrier(s) used to import taxable fuel and the taxable fuel
imported.
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Name of Carrier(s) and Address
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Taxable Fuel Imported
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TERMINAL
OPERATOR
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Provide
the name, telephone number, and address of all terminal managers.
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Name of Terminal Manager
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Telephone Number
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Address of Terminal
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Is
the entity a for hire terminal?
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Does
the entity dye diesel fuel at the terminal? If so, describe the
dye injection system used.
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Does
the entity own any of the products in the terminal(s)? If so,
specify the products owned?
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Provide
a schematic of each terminal the entity owns and/or operates.
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Provide the names of the companies that
verify the unloading of barges into terminal(s)?
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List the names and 637 Numbers of all
Position Holders in the terminal(s), and identify the taxable
fuel stored.
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Position Holder’s Name
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637 Registration Number
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Taxable Fuel Stored
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What
does the entity do with transmix? Indicate how the transmix is
received. Provide the name and address of the carrier(s) if not
previously listed.
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Name and Address of Carrier(s)
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Mode of Transportation
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INDUSTRIAL
USER
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List
the gasoline blendstock(s) the entity purchases or intend to
purchase.
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How
will the gasoline blendstock(s) be received by the entity?
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For
what purpose will the entity be using the gasoline blendstock(s)?
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Have
any gasoline blendstock(s) been resold, or plan to be resold?
If so to whom?
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THROUGHPUTTER/POSITION HOLDER
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Indicate
where the entity owns or will own taxable fuel in the bulk
transfer/terminal system.
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Bulk Transfer/Terminal System
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YES
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NO
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Refinery
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Pipeline
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Vessel
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Terminal
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List the name, address and Form 637
Registration Number of any other party who will pull taxable fuel
from the entity’s position at the terminal(s). CEP or large
oil companies may be exempted from this question.
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Name and Address of Other Party
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637 Registration Number
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Describe the records used to determine
the receipt and/or removal of taxable fuel from the terminal(s)
in which taxable fuel is being stored.
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Acceptable Risk Test
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Has
the entity or a related person been penalized for a wrongful act?
If yes, explain. (For
initial registrations, review the applicant’s responses to
the questions listed in Part III, Section C, Page 2 of Form 637.)
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Explanation:
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Adequate Security Test
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Complete
Form 637 Reengineering Forms: A620,
B700,and
B705
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Does
the entity have both adequate financial resources and a
satisfactory tax history?
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A620,
B700, & B705
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