Form EIA-821 Annual Fuel Oil and Kerosene Sales Report

U.S. DEPARTMENT OF ENERGY U.S. Energy Information Administration

OMB No.: 1905-0174 Form Expires: XX/XX/XXXX Burden: 4.4 hours

FORM EIA-821 ANNUAL FUEL OIL AND KEROSENE SALES REPORT

REFERENCE YEAR 2016

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. RESPONDENT IDENTIFICATION DATA

For assistance in completing this form call 1-800-638-8812

Provide corrections to Company Name, Address, and Contact information in items 1-8

1. Company Name

8. Contact Information :

a. Name b. Telephone Number ( ) - c. Fax Number ( ) - d. Email Address

2. Doing Business As (DBA)

3. Physical Address (e.g., Street Address, Building, Floor, Suite)

4. Mailing Address (e.g., PO Box, RR)

5. City

6. State

7. Zip Code

9. Reference Year 2016

10. Type of Report (Check One): a. □ Original b. □ Resubmission

11. The number of States in which your firm sells Fuel Oil and/or Kerosene to Energy Users.

12. Which of the following best describes this firm at the end of 2016?

13. Effective Date of Status Change

Month

Day

Year

a. □ In operation – Sales include petroleum products b. 1. □ Sold 2. □ Merged 3. □ Leased c. □ Subsidiary of another d. □ Commissioned Agent e. □ Permanently ceased operation f. □ Not in the petroleum business

Skip to and complete items 22-25 and Part 2 Complete items 13-25, and Part 2 for that portion of 2016 in which the firm was active under your ownership and control Complete item 13, then skip to and complete items 22-25 and Part 2 for that portion of 2016 in which the firm was active under your ownership and control Skip to and complete items 22-25

14. Company Name

15. Doing Business As (DBA)

16. Physical Address (e.g., Street Address, Building, Floor, Suite)

17. Mailing Address (e.g., PO Box, RR)

18. City

19. State

20. Zip Code

21. Contact Information: a. Name b. Telephone Number ( ) - c. Fax Number ( ) - d. Email Address

PREPARED BY: Check appropriate box. If preparer is different from contact person, complete lines 24 and 25.

22. □ Preparer same as contact person shown on label □ Preparer is not the same as contact person shown on label

23. Date

24. Preparer’s Name

25. Preparer’s Telephone Number

Name of Firm Reporting

EIA ID Number

Reference Year 2016

Page of

PART 2. TOTAL SALES DURING THE REFERENCE YEAR. (Read pages 2-4 of the instructions)

Line No.

Type of Fuel and Use

States of Destination (Enter Standard Abbreviations. See page 6 of the instructions)

Kerosene (Report in Actual Gallons)

Sold directly to consumers for:

1

Residential Use (Non-Farm):

2

Commercial Use:

3

Industrial Use:

4

Farm Use:

5

All Other Uses (Including own company, please specify):

6

Sold to Dealers, Resellers, and Refiners:

7

Total Kerosene (Add Lines 1 thru 6)

Distillate Fuel Oil (Report in Actual Gallons)

Sold directly to consumers for:

Residential Use (Non-Farm):

8

No. 1

9

No. 2

Commercial Use (See Reference Guide):

Report sales of diesel for automobiles, trucks, buses, and school buses on Line 39, under On-highway Diesel Use, with the exception of government vehicles which should be reported on Line 12.

10

No. 1

11

No. 2 Fuel Oil

12

No. 2 Diesel ≤ 15 ppm Sulfur, Ultra Low

13

No. 2 Diesel > 15 and ≤ 500 ppm Sulfur, Low

14

No. 2 Diesel > 500 ppm Sulfur, High

15

No. 4

Industrial Use (Manufacturing and Mining):

16

No. 1

17

No. 2 Fuel Oil

18

No. 2 Diesel ≤ 500 ppm Sulfur, Low (include Ultra Low Sulfur)

19

No. 2 Diesel > 500 ppm Sulfur, High

20

No. 4

Oil Company Use (Drilling and Own Company Refining):

21

No. 2 Diesel ≤ 500 ppm Sulfur, Low (include Ultra Low Sulfur)

22

No. 2 Diesel > 500 ppm Sulfur, High

23

Other Distillate

Railroad Use:

24

No. 2 Diesel ≤ 500 ppm Sulfur, Low (include Ultra Low Sulfur)

25

No. 2 Diesel > 500 ppm Sulfur, High

26

Other Distillate

Name of Firm Reporting

EIA ID Number

Reference Year 2016

Page of

PART 2. TOTAL SALES DURING THE REFERENCE YEAR. (Read pages 2-4 of the instructions)

Line No.

Type of Fuel and Use

States of Destination (Enter Standard Abbreviations. See page 6 of the instructions)

Distillate Fuel Oil – continued (Report in Actual Gallons)

Vessel Bunkering (Shipping and Boating):

27

No. 2 Diesel ≤ 500 ppm Sulfur, Low (include Ultra Low Sulfur)

28

No. 2 Diesel > 500 ppm Sulfur, High

29

Other Distillate

Military Use:

30

No. 2 Diesel ≤ 500 ppm Sulfur, Low (include Ultra Low Sulfur)

31

No. 2 Diesel > 500 ppm Sulfur, High

32

Other Distillate

Electric Power Use (Electric utility and Nonutility):

33

No. 2 Diesel ≤ 500 ppm Sulfur, Low (include Ultra Low Sulfur)

34

No. 2 Diesel > 500 ppm Sulfur, High

35

Other Distillate

Farm Use:

36

No. 2 Diesel ≤ 500 ppm Sulfur, Low (include Ultra Low Sulfur)

37

No. 2 Diesel > 500 ppm Sulfur, High

38

Other Distillate

On-highway Diesel Use:

Report No.1 and No. 2 Diesel Fuel

39

Diesel ≤ 15 ppm Sulfur, Ultra Low

40

Diesel > 15 and ≤ 500 ppm Sulfur, Low

Off-highway Use: Construction:

41

No. 2 Diesel ≤ 500 ppm Sulfur, Low (include Ultra Low Sulfur)

42

No. 2 Diesel > 500 ppm Sulfur, High

43

Other Distillate

Off-highway Use: Other (Specify e.g., Logging):

44

No. 2 Diesel ≤ 500 ppm Sulfur, Low (include Ultra Low Sulfur)

45

No. 2 Diesel > 500 ppm Sulfur, High

46

Other Distillate

47

All Other Uses (Specify):

48

Sold to Dealers, Resellers, and Refiners:

49

Total Distillate (Add Lines 8 thru 48)

Name of Firm Reporting		EIA ID Number	Reference Year 2016	Page of
PART 2. TOTAL SALES DURING THE REFERENCE YEAR. (Read pages 2-4 of the instructions)
Line No.	Type of Fuel and Use	States of Destination (Enter Standard Abbreviations. See page 6 of the instructions)
Residual Fuel Oil – No. 5 and No. 6 (Report in Actual Gallons)
	Sold directly to consumers for:
50	Commercial Use (Nonmanufacturing):
51	Industrial Use (Manufacturing and Mining):
52	Oil Company Use (Drilling and Own Company Refining):
53	Vessel Bunkering (Shipping and Boating):
54	Military Use:
55	Electric Power Use (Electric utility and Nonutility):
56	All Other Uses (Specify):
57	Sold to Dealers, Resellers, and Refiners:
58	Total Residual (Add Lines 50 thru 57)

How to Submit Forms:
Secure File Transfer option available at:	https://signon.eia.doe.gov/upload/noticeoog.jsp
Fax form to:	1-202-586-9772, Attn: EIA-821
Mail form to:	Oil & Gas Survey U.S. Department of Energy (EI-25) Attn: EIA-821 Ben Franklin Station PO Box 279 Washington, DC 20044-0279

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