Form EIA-457D 2024 RECS Propane Usage

EIA-457D
OMB 1905-0092
Exp. X/XX/202X
Burden: 10 minutes

2024 RECS Propane (Bottled Gas or LPG) Usage Form
Delivery address:
123 Main St.
Apt. 1
Anytown, US 98765

Account number:

Please provide information on propane usage for this delivery address between September 2023 and April 2025.
If you have no data for this delivery address, please submit this form without filling in any data and leave a comment
explaining the situation.

Delivery
number

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

Enter the
delivery date
for each
delivery
MM/DD/YY

Type of fuel
sold was:
P = Propane
B = Butane
O = Other
(circle one)
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P

B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B

O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O

Select the unit of measure
o Gallons
o Pounds
Enter the amount
delivered
XXXX

Enter the total dollar amount
including taxes
[Exclude late fees,
merchandise, repairs, and
service charges]
$XXX.XX

If the type of fuel sold above was O = Other, enter the specific type of fuel here. If a mixture of fuels was sold,
enter the types of fuel and proportion of each:
Comments: