Standard Fuel Receipt

Gas · Simple pump receipt layout

Store Information

Store Name / Abbreviation

Street Address

City, State ZIP

Store # optional — prints as ST#

Cashier # CSH:

Drawer # DR#

Date

Time

Enter T in the Tax column for taxable items, or leave blank for non-taxable.

Qty Description Tax Unit Price

Sales Tax Rate (%)

Payment Method

Currency Symbol

Card Last 4 Digits optional

Auth Code optional

Entry Method

App / Card Name AppName

AuthNet

AID Code optional

Resp Code

Stan # auto-generated if blank

Invoice # auto-generated if blank

Cancel