OIMB/COR#027-COCD

DEPARTMENT OF ENERGY
Energy Center, Rizal Drive
BGC, Taguig City

Name of Dealer : _________________________________________

Ellaine Reyes De Vera Telephone No. : ___________________________________
Business Name : _________________________________________
Rosario Star Fuel Gasoline Station Mobile Phone No. : ___________________________________
09394579151
Business Address : _________________________________________
Mc Arthur Hi-Way Subusub Rosario La Union Email Address : ___________________________________
deveraellaine@yahoo.com
_________________________________________
Supplier : _________________________________________
Northern Star

DATA ON SALES (LIQUID FUELS)

For the year 20 ___
18

Product January February March April May June July August September October November December

Sales Volume (in liters)

Regular 26,998.08324,669.561 21,982.56 24,207.745 32,558.337 23,310.814 20,793.561 22,562.11 26,477.487 19,457.78 23,468.731 30,255.901

Premium 22,845.36 35,468.223 21,982.56 35,308.82 42,941.372 28,453.57 29,807.8463 28,648.783 30,687.682 54,641.917 20,878.414 32,553.128

Premium Plus

Diesel 66,163.30 70,587.33 72,006.52 82,683.899 78,925.195 67,211.833 61,064.561 79,862.721 61,782.56 57,482.56 77,718.234 71,751.828

Diesel Plus

Kerosene

Total (in liters) 116,006.743 130,745.114 115,971.64 142,200.464 154,424.904 118,976.217 111,665.9683 131,067.614 118,947.729 131,582.257 122,065.379 134,560.857

Total Sales Volume for the year (in liters) _____________________

1,528,234.8863

Prepared by: ____________________________________

VICTOR A PUNZALAN Date: ________________
01/30/2019
(Signature of Dealer/Operator Over Printed Name)

SUBSCRIBED AND SWORN TO before me this ___ day of _________ 20__ in ___________ City, affiant exhibiting to me his/her
on _________________________ at _______________________.

Doc. No. Notary Public

Page No.
Book No.
Series of _______.