COMMERCIAL-IN-CONFIDENCE (When Completed) Biofuels Return Use this form to: furnish a return as required under section 11 of the Biofuels Act 2007 To complete this return: Read the instructions carefully. If you need further assistance please email bio.fuels@trade.nsw.gov.au or telephone (02) 9995 0496. Print clearly using a BLUE or BLACK pen only. Use BLOCK LETTERS and print one character per box, e.g: 2 0 1 3 Scan and email to: bio.fuels@trade.nsw.gov.au or post to: Office of Biofuels Division of Resources and Energy Department of Trade & Investment, Regional Infrastructure & Services GPO Box 7060 SYDNEY NSW 2001 1. Volume Fuel Seller’s details: Name: Business Address: Registered Volume Fuel Seller of: (tick as appropriate) Petrol/Ethanol and Diesel/Biodiesel (complete all sections) Petrol/Ethanol only (complete all sections except section 4) Diesel/Biodiesel only (complete all sections except section 3) Australian Company Number (ACN): 2. Quarterly Return for: Day Period 3. From Month / Year / Day to Month Year / / Petrol and Ethanol Sales Volumes 1 2 3 Total volume of petrol (including petrol-ethanol blend) sold to a person in NSW or for delivery in NSW (litres), excluding sales of petrol to another registered volume fuel seller of petrol. Total volume of ethanol sold (in the form of petrol-ethanol blend) to a person in NSW or for delivery in NSW (litres) excluding sales to another registered volume fuel seller of petrol. Volume of ethanol sold (as set out in column 2) expressed as a percentage against the volume of petrol sold (as set out in column 1). Only ethanol that complies with a biofuel sustainability standard* may be counted. Total for Quarter * The document entitled Global Principles and Criteria For Sustainable Biofuels Production—Version Zero, published by the Roundtable on Sustainable Biofuels on 13 August 2008, is prescribed as a standard in respect of the sustainable manufacture of ethanol. COMMERCIAL-IN-CONFIDENCE (When Completed) Biofuels Return COMMERCIAL-IN-CONFIDENCE (When Completed) Volume fuel seller name: Day Period 4. From Month / Year / Day Month Year / to / Diesel and Biodiesel Sales Volumes 1 Total volume of diesel fuel (including biodieseldiesel blend) sold to a person in NSW or for delivery in NSW (litres) excluding sales of diesel fuel to another registered volume fuel seller of diesel fuel. 2 3 Total volume of biodiesel sold (in the form of biodiesel-diesel blend) to a person in NSW or for delivery in NSW (litres) excluding sales to another registered volume fuel seller of diesel fuel. Volume of biodiesel sold (as set out in column 2) expressed as a percentage against the total volume of diesel fuel sold (as set out in column 1). Only biodiesel that complies with a sustainability standard* may be counted. Total for Quarter * The document entitled Global Principles and Criteria For Sustainable Biofuels Production—Version Zero, published by the Roundtable on Sustainable Biofuels on 13 August 2008, is prescribed as a standard in respect of the sustainable manufacture of biodiesel. 5. Declaration I am authorised by the volume fuel seller referred to in this return to complete the return and specify the information contained in it. I declare that to the best of my knowledge the information given in this return is true and complete. I understand that it is an offence to furnish a return containing information that is false or misleading in a material particular. The volumes reported herein include all sales by this volume fuel seller to a person in NSW or for delivery in NSW, except sales by this volume fuel seller to another volume fuel seller of petrol and/or diesel fuel (as applicable). Only biofuels that comply with the biofuel sustainability standard established in the document entitled Global Principles and Criteria For Sustainable Biofuels Production—Version Zero, published by the Roundtable on Sustainable Biofuels on 13 August 2008, have been counted towards the volumes of biofuels reported in this return. Name Position Telephone Fax Email Signature Day Month / Privacy Year / Complaints, comments or suggestions: Any personal information which is provided in this return is protected by the Privacy and Personal Information Protection Act 1998 (NSW) and the Health Records and Information Privacy Act 2002 (NSW).The information will be used by the Department to monitor and enforce compliance with the Act. Please refer to our website http://www.trade.nsw.gov.au/legal/privacy for more information on our privacy policy and your rights to access or correct the information. The information may be used to send you communications such as newsletters, flyers and invitations about business-related activities. We value your complaints, comments and suggestions and use them to improve our processes and the service we provide to you. If you would like to discuss any biofuel service or product, we invite you to phone us on (02) 9995 0496 or email us at: bio.fuels@trade.nsw.gov.au COMMERCIAL-IN-CONFIDENCE (When Completed) Page 2