Fuel Purchase Log

FUEL PURCHASE PRICE LOG
Instructions: Enter the vessel name, registration number, and main engine
horsepower at the left. When you purchase fuel, provide the date, number
of gallons, price per gallon, port or city and state where you purchased the
fuel in the spaces provided below.

Registered Vessel Name
State Vessel Reg. No.
Main Engine Horsepower

DO NOT REMOVE OR MAIL THESE SHEETS.
THIS INFORMATION WILL BE PERIODICALLY COLLECTED BY STATE PERSONNEL

Date

# Gallons

Price/Gallon

Port/City

State

Date

# Gallons

Price/Gallon

Port/City

State