Form EIA-863 Petroleum Product Sales Identification Survey

U.S. DEPARTMENT OF ENERGY
U.S. Energy Information Administration
Washington, DC 20585

YYYY

OMB No. 1905-0174
Expiration Date: XX/XX/XXXX
Burden: 1 hour

EIA-863: PETROLEUM PRODUCT SALES IDENTIFICATION SURVEY

This report is mandatory under the Federal Energy Administration Act of 1974 (Public Law 93-275). Failure to comply may result in criminal f ines, civ il
penalties and other sanctions as prov ided 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 f or
f urther details on the sanctions.

PART 1. RESPONDENT IDENTIFICATION DATA

Begin here and follow numerical order
unless instructed otherwise.
Please prov ide corrections to company name, address,
contact information, and telephone number in items 1 thru 8.
1a. Company Name (only if different than the label)
1b. Is company name change a result of a previous sale,
merge, lease, or becoming a subsidiary since 20XX?
 Yes
 No
1c. Doing business as (If different than company name)
2. Name of Contact Person
3. Contact’s Telephone Number
3a. Contact’s Email
4. Physical Address (e.g., Street Address, Building, Floor, Suite)
5. Mailing Address (e.g., PO Box, RR)

For assistance in com pleting this form call 1-855-342-4872

6. City

7. State

8. ZIP Code

The information reported in items 1-8 of Part I, Respondent Identification Data, of the EIA-863 will be protected and not disclosed to the public to the extent that it satisfies the
criteria for exemption under the Freedom of Information Act (FOIA), 5 U.S.C. §552, the Department of Energy (DOE) regulations, 10 C.F.R. §1004.11, implementing the FOIA, and
the Trade Secrets Act, 18 U.S.C. §1905.
With regard to the information reported in items 1-8 of Part I, the Federal Energy Administration Act requires the
when requested for official use. That information reported in Part I may also be made available, upon request, to
the Government Accountability Office, or other Federal agencies authorized by law to receive such information.
response to an order. That Part I information may be used for any non-statistical purposes such as administrative,

EIA to provide company-specific data to other Federal agencies
another component of the DOE; to any Committee of Congress,
A court of competent jurisdiction may obtain this information in
regulatory, law enforcement, or adjudicatory purposes.

The information reported in Part 1 item 9-18, Parts II, Preparer Information, and III, Total Sales Volumes by State, of the EIA-863 will be used for statistical purposes only and is
confidential by law. In accordance with the Confidential Information Protection and Statistical Efficiency Act of 2018 and other applicable Federal laws, your responses to Part I
item 9-18, Parts II and III of Form EIA-863 will not be disclosed in identifiable form without your consent. Per the Federal Cybersecurity Enhancement Act of 2015, Federal
information systems are protected from malicious activities through cybersecurity screening of transmitted data. Every EIA employee, as well as every agent, is subject to a jail
term, a fine, or both if he or she makes public ANY identifiable information you reported.

9.
a.

Which of the following best describes your company’s operating status
at the end of 20XX? (Check only 1 box)
 Your company is in operation—
sales include petroleum products.

b1.  Your company was sold, or
you merged with another
company.
b2.  You leased your company to
another company.
c.



d.



e.

f.

Your company has permanently
ceased operation.
Your company is a subsidiary of
another company and all or some
of your sales are reported by
another company.

Your company is a commissioned
agent for another company and all
or some of your sales are reported
by another company.
 Your company does not sell any
petroleum products.


Skip Items 10 thru 18.
Complete Parts II and III.
Complete items 10 thru
18. Also complete Part II
and Part III for the portion
of 20XX that you owned
and operated the
Company.
Complete item 10 (date
ceased) and Part II.

10. Enter the date your company sold, merged, leased, ceased
operation, became a subsidiary, or became a
commissioned agent:
Month

Day

Y ear

11. Enter name of the company you sold to/merged with/leased
to/became a subsidiary of or commissioned agent for:
12. Enter name of the contact person of company in Item 11:
13. Contact’s Telephone Number
-

-

Complete items 10 thru 18
Also, complete Part II and
Part III for the portion of
20XX that you owned and
operated the company.

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

Complete Part II and return

16. City

(see instructions for “Where
to Submit”)

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

17. State

18. ZIP Code

EIA-863 (YYYY)

Page 2

Company Name

EIA ID Number

Reference Year

YYYY

PART 2. PREPARER INFORMATION

Page______ of______

19. Preparer’s Name

20a. Telephone Number

20b. Date

20c. Email Address

21. Fax Number

22. FOR EIA USE ONLY

Comments:

PART 3. TOTAL SALES VOLUMES (BY STATE) FOR 20XX (REPORT IN ACTUAL GALLONS)

23. Did your company sell No. 2 Distillate, No. 5 and No. 6 Residual Fuel Oil, Motor Gasoline, and/or Propane in 20XX?
a.
Yes . . . . . Answ er item 24
b.
No . . . . . Skip to item 25
24. Enter below in lines “a” through “p” your company’s total annual sales volumes in each State for the entire year of 20XX
(report in actual gallons). Include all sales made by your divisions, branches, outlets, and subsidiaries. Report a sale in the
State w here the transfer of ow nership occurred
PLEASE NOTE: Enter the state you are reporting for in the blocks below using the 2-digit state abbreviation. If you have
sales in more than tw o states make a copy of Part III, record your other states and attach to the original form. State
abbreviations are listed on the last page of this form for your convenience.

PETROLEUM CATEGORY

No. 2 Distillate Fuel Oil and No. 2 Diesel – please
provide volumes for all that apply.
a.

No. 2 Fuel Oil for all other end uses (Include apartment

c.

No. 2 Diesel Fuel for all other end uses (Include

buildings; Exclude diesel fuel oil and gasoline.)

agricultural use and on-highway use; Exclude gasoline.)

d.

No. 2 Fuel Oil sold to Dealers, Resellers, and Refiners
w ho w ill resell the product (Exclude gasoline.)

e.

No. 2 Diesel sold to Dealers, Resellers, and Refiners
w ho w ill resell the product (Exclude gasoline.)

f.

Total No. 2 Fuel Oil and
No. 2 Diesel sold in YYYY.

(Add lines a thru e and
enter amount here)

No. 5 and No. 6 Residual Fuel Oil – please provide
volumes for all that apply.

Volum es

(report in actual gallons)

Volum es

(report in actual gallons)

No. 5 and No. 6 Fuel Oil sold to the Consum er

(Examples: to electric utilities, to vessels for bunkering, to
industrial and commercial users, to military.)

h.

No. 5 and No. 6 Fuel Oil sold to Dealers, Resellers,
and Refiners w ho w ill resell the product.

i.

Total No. 5 and No. 6 Fuel Oil
sold in YYYY.

(Add lines g thru h and
enter amount here)

Motor Gasoline and Gasohol – please provide

volumes for all that apply. (Report Gasohol and
Oxygenated Gasoline under Conventional, and include
OPRG under Reformulated.)
j.

Volum es

(report in actual gallons)

No. 2 Residential Fuel Oil sold for heating private
homes (Include heating farm houses; Exclude apartments.)

b.

g.

Volum es

(report in actual gallons)

Motor Gasoline and Gasohol sold to the Consum er.
(Include all grades of gasoline; Exclude No. 2 diesel and
aviation gasoline.)

k.

Motor Gasoline sold to Dealers, Resellers, and
Refiners w ho w ill resell the product. (Include rack and

l.

Total Motor Gasoline sold
in YYYY.

DTW sales.)

(Add lines j thru k and
enter amount here)

Conventional
Gasoline
(report in actual
gallons)

Reformulated
Gasoline
(report in actual
gallons)

Conventional
Gasoline
(report in actual
gallons)

Reformulated
Gasoline
(report in actual
gallons)

EIA-863 (YYYY)

Page 3

Company Name

EIA ID Number

Reference Year

YYYY

PLEASE ENTER THE 2-LETTER STANDARD STATE ABBREVIATION

Page ______of _______

PETROLEUM CATEGORY
Volum es

Propane – please provide volumes for all that apply.
m.
n.
o.
p.
25.

26.

Volum es

(report in actual gallons)

Delivered Residential Propane. (Home heating, including
farm houses.)

Propane sold to Custom ers for all other end uses.
(Include commercial, industrial, agricultural, and propane
powered motor vehicles.)

Propane sold to Dealers, Resellers, and Refiners w ho
w ill resell the product.
Total Propane sold in YYYY.

(Add lines m thru o and
enter amount here)

Does your company sell any of these other petroleum products? Check boxes for all that you sell. (Other does not include No. 2
Fuel Oil and No. 2 Diesel, No. 5 and No. 6 Residual Fuel Oil, Motor Gasoline, and Propane for which you have already reported
volumes.)
a. 

Kerosene

b. 

No. 1 Distillate

c. 

Crude Oil

d. 

Other LPG

e. 

No. 4 Fuel Oil

f.

Aviation Gasoline

g. 

Jet Fuel

h. 

Other:___________________________



(Specify)

Does your company sell and/or use propane for on-highw ay transportation use? Check appropriate box(es).
a.  Sell

27.

(report in actual gallons)

b. 

Use

c.  No

Does this firm currently sell (or has it ever sold) distillate fuel oil to railroad companies?
a.  Yes

b. 

No

Please submit this form to EIA by March 30, YYYY.
For submission by mail:

by fax:
by secure file transfer:

Oil and Gas Survey
U.S. Departm ent of Energy (EI-23)
Attn: EIA-863
Ben Franklin Station
PO Box 279
Washington, DC 20044-0279
1-202-586-9772
https://signon.eia.doe.gov/upload/noticeoog.jsp
See Section 6 in the instructions for additional
information on how to file the EIA-863 electronically.

Page 4

LIST OF STANDARD STATE ABBREVIATIONS

AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS

...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...

Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas

KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC

...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...

Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina

ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY

... North Dakota
... Ohio
... Oklahoma
... Oregon
... Pennsylvania
... Rhode Island
... South Carolina
... South Dakota
... Tennessee
... Texas
... Utah
... Vermont
... Virginia
... Washington
... West Virginia
... Wisconsin
... Wyoming