Form EIA-888 (Schedule EIA-888 (Schedule On-Highway Diesel Fuel Price Survey (Schedule A)

U.S. DEPARTMENT OF ENERGY
U.S. ENERGY INFORMATION ADMINISTRATION
Washington, DC 20585

OMB No. 1905-0174
Expiration Date: XX/XX/XXXX
Burden: 5 minutes

EIA-888
ON-HIGHWAY DIESEL FUEL PRICE SURVEY
Schedule A
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 know ingly and w illingly to make
to any Agency or Department of the United States any false, fictitious, or fraudulent statements as to any matter w ithin its j urisdiction. See
Instructions for further details on the sanctions and the provisions concerning the confidentiality of information submitted on this form.

PART 1. IDENTIFICATION DATA
Company Name
Name of Contact Person
Contact’s Telephone Number
City

State

Zip Code

Prices for:
Month

Day

EIA ID No.

PART 2. PRICE DATA
(Enter the retail price of self-service, cash only, on-highway diesel fuel, including all taxes)
Date Called

COMMENTS

Price

Year