mileage report continuation sheet - Oregon Department of ...

OREGON DEPARTMENT OF TRANSPORTATION
MOTOR CARRIER TRANSPORTATION DIVISION
550 CAPITOL ST NE
SALEM OR 97301-2530
MILEAGE REPORT CONTINUATION SHEET
INSTRUCTIONS: THIS CONTINUATION SHEET MUST BE ATTACHED TO YOUR MOTOR CARRIER MILEAGE TAX REPORT AND SHOULD BE USED
ONLY WHEN ADDITIONAL SPACE IS REQUIRED FOR LISTING ADDITIONAL VEHICLES.
MCTD ACCOUNT NUMBER NAME OF CARRIER
PERIOD OF OPERATION
A
LICENSE PLATE
OR
PASS NUMBER
B C D E
STATE/
PROV.
UNIT
NUMBER
MAKE OF
VEHICLE
DECLARED
WEIGHTS
F
ODOMETER READINGS
BEGINNING
G
ENDING
H I J
NO. OF
K L
TOTAL OREGON
TAX RATE
AXLES
MILES TAXABLE
PER MILE
IF USING
OPERATED MILES
(Decimal)
TABLE "B"
OREGON
HIGHWAY
USE TAX
FORM 735-9002A (6-09) STK# 320005
(OVER)

MCTD ACCOUNT NUMBER
NAME OF CARRIER
PERIOD OF OPERATION
A
LICENSE PLATE
OR
PASS NUMBER
B C D E H I J
STATE/ UNIT MAKE OF
ODOMETER READINGS
NO. OF
K L
DECLARED
TOTAL OREGON
TAX RATE
AXLES
PROV. NUMBER VEHICLE WEIGHTS
MILES TAXABLE
PER MILE
F
G
IF USING
BEGINNING
ENDING OPERATED MILES
(Decimal)
TABLE "B"
OREGON
HIGHWAY
USE TAX