flat monthly report continuation sheet - Oregon Department of ...
flat monthly report continuation sheet - Oregon Department of ...
flat monthly report continuation sheet - Oregon Department of ...
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OREGON DEPARTMENT OF TRANSPORTATION<br />
MOTOR CARRIER TRANSPORTATION DIVISION<br />
550 CAPITOL ST NE<br />
SALEM OR 97301-2530<br />
FLAT MONTHLY REPORT CONTINUATION SHEET<br />
INSTRUCTIONS: This <strong>continuation</strong> <strong>sheet</strong> must be attached to your MOTOR CARRIER FLAT MONTHLY TAX REPORT and should be used only when<br />
additional space is required for listing additional vehicles . You must use your approved fee basis.<br />
MCTD ACCOUNT NUMBER<br />
NAME OF CARRIER<br />
PERIOD OF OPERATION<br />
A<br />
LICENSE PLATE<br />
OR<br />
PASS NUMBER<br />
B C D MONTHLY<br />
G<br />
H<br />
I<br />
J<br />
K L<br />
STATE/<br />
ODOMETER READINGS<br />
TOTAL PRIVATE OREGON<br />
ENTER<br />
UNIT OREGON<br />
NO. OF<br />
MILES RD & OUT- PUBLIC<br />
C- CHIP<br />
PROV. NUMBER DECLARED E<br />
F<br />
AXLES<br />
OPERATED<br />
ROAD MILES<br />
D - DUMP<br />
WEIGHTS<br />
BEGINNING<br />
ENDING<br />
OF-STATE<br />
>80000<br />
(F-E) MILES (G-H)<br />
L -LOG<br />
20<br />
FLAT<br />
MONTHLY<br />
FEE<br />
FORM 735-9189a (8-08) STK# 320185
A<br />
LICENSE PLATE<br />
OR<br />
PASS NUMBER<br />
B C D MONTHLY<br />
G<br />
H<br />
I<br />
J<br />
K L<br />
STATE/<br />
ODOMETER READINGS<br />
TOTAL PRIVATE OREGON<br />
ENTER<br />
UNIT OREGON<br />
NO. OF<br />
MILES RD & OUT- PUBLIC<br />
C- CHIP<br />
PROV. NUMBER DECLARED E<br />
F<br />
AXLES<br />
OPERATED<br />
ROAD MILES<br />
D - DUMP<br />
WEIGHTS<br />
BEGINNING<br />
ENDING<br />
OF-STATE<br />
>80000<br />
(F-E) MILES (G-H)<br />
L -LOG<br />
FLAT<br />
MONTHLY<br />
FEE
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