(1) All liquefied gas special fuels sold, delivered, or used by the dealer, whether the liquified gas special fuels are sold or delivered for a taxable or nontaxable use;
(2) The name and address of the purchasers;
(3) The quantity purchased by each; and
(4) In the case of liquefied gas special fuels delivered into the supply tanks of vehicles on which the flat fee provided in this subchapter has been paid, the name, address, and vehicle license number of the purchaser.
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