Form EIA-888 On-Highway Diesel Fuel Price Survey

U.S. DEPARTMENT OF ENERGY U.S. ENERGY INFORMATION ADMINISTRATION Washington, DC 20585

OMB No. 1905-0174 Expiration Date: xx/xx/xxxx Burden: 3 minutes

EIA-888

ON-HIGHWAY DIESEL FUEL 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 1. IDENTIFICATION DATA

Company Name

Name of Contact Person

Contact’s Telephone Number

-

-

City

State

Zip Code

Prices for:

Month

Day

Year

EIA ID No.

PART 2. PRICE DATA

(Enter the retail price of self-service, cash only, on-highway diesel fuel, including all taxes)

Date Called	Price

Comments: