Eg Name of Dealer B Name Per Product DEPARTMENT OF ENERGY Energy Center, Rizal Drive GC, Taguig City ‘Telephone No. = Mobile Phone No. acer Email Address DATA ON TOTAL RUNNING INVENTORY (LIQUID FUELS) For the year 20 __ co1me/consoze-coco Month Beginning Balance Purchases Sales Running Balance January February March April May une sly August September October Novernber December SUBSCRIBED AND SWORN TO before Doe. No. Page No. Book No. Series of _ a Notary Publiccommeycors027-coco DEPARTMENT OF ENERGY Energy Center, Rizal Drive BGC, Taguig Name of Dealer Supplier DATA ON SALES (LIQUID FUELS) For the year 20__ Product January | February] March | April May June July | August [September] October | November] December ISalés Volume (in liters) Regular Premium Premium Plus Diesel Diesel Plus Kerosene [Total (in titers) Total Sales Volume for the year (In liters) Propared by: Pigg signature of Dealer/Operator Over Printed Name) __ City, affiant exhibiting to me his/her on _at : Doc. No, Notary Public Page No. Book No. Series ofEg Name of Dealer Business Name Business Address Supplier DEPARTMENT OF ENERGY Energy Center, Rizal Drive GC, Taguig City Telephone No, Mobile Phone No, Email Address DATA ON PURCHASES (LIQUID FUELS) For the year 20___ ‘o1ms/consor6-coco Product January | February | March April May June July | August JSeptember| October | November] December| Purchases (in liters) Regular Premium Premium Plus Diesel Diesel Plus Kerosene Total Purchases for the year (in liters) __ SUBSCRIBED AND SWORN TO before me this ___ day of on - o_ Doc. No. Page No. Book No. Series of. Prepared by: Gi _ City, affiant exhi Date: ture of Deeler/Operator Over Printed Name) Notary Public