DS-1504 Bonded Warehouse Ordering (eGov)

DS-1504 Form / Gasoline Tax Exemption Request: eGov pages

Data items collected by the eGov Bonded Warehouse Ordering Exemption request but not collected by the DS-1504 Form;

1. Warehouse

2. Intended Use

3. Order Point of Contact or Consignee: Date of Birth

4. Delivery Address:

   1. Address Line 1

   2. Address Line 2

   3. City

   4. State

   5. ZIP Code

5. Mission Property Address

6. Remarks

Page 3 of 3