Gas Station Receipt Template

A pump receipt example showing fuel grade, gallons dispensed and price, plus a convenience-store item — the standard forecourt printout.

Zuletzt aktualisiert: 23. Oktober 2026

SUMMIT FUEL STOP

1200 Ridge Route

Hillcrest, ST 00000

(555) 343-8800

10/24/2026 06:16 PM

1	Premium 93 — 9.86 gal	$42.30
1	Coffee 16oz	$2.19

Zwischensumme$44.49

Steuer (6%)$2.67

GESAMT$47.16

KARTEVISA ****4021

Pump 07 — Come again!

Summit Fuel Stop Diesen Beleg anpassen →

ROUTE 9 FUEL

900 Highway 9

Crossroads, ST 00000

(555) 052-9090

10/24/2026 06:16 PM

1	Unleaded 87 — 11.42 gal	$39.85
1	Windshield Fluid	$3.99

Zwischensumme$43.84

Steuer (6%)$2.63

GESAMT$46.47

KARTEVISA ****4021

Pump 04 — Thank you!

Route 9 Fuel Diesen Beleg anpassen →

Beispielbeleg — alle Firmennamen sind fiktiv.

Related templates

OLIVE & THYME KITCHEN

44 Vineyard Street

Westbrook, ST 00000

(555) 310-2244

10/24/2026 06:16 PM

1	Grilled Salmon	$21.00
1	Pasta Primavera	$16.50
2	Glass of Wine	$16.00
1	Tiramisu	$7.50

Zwischensumme$61.00

Steuer (8.5%)$5.19

GESAMT$66.19

KARTEVISA ****4021

Server: Dana — Table 12. Thank you!

Restaurantbeleg-Vorlage

THE LANTERN HOTEL

200 Grand Avenue

Westbrook, ST 00000

(555) 321-9080

10/24/2026 06:16 PM

3	Standard King — Night	$447.00
1	Room Service	$32.50
3	Resort Fee	$45.00

Zwischensumme$524.50

Steuer (11%)$57.70

GESAMT$582.20

KARTEVISA ****4021

Folio #55821 — Checkout 11:00 AM.

Hotelbeleg-Vorlage

Taxiquittung-Vorlage

Parkbeleg-Vorlage

HARVEST LANE MARKET

75 Meadow Parkway

Hillcrest, ST 00000

(555) 365-2323

10/24/2026 06:16 PM

2	Organic Apples / lb	$3.98
1	Greek Yogurt 32oz	$5.29
1	Chicken Breast / lb	$4.89
1	Pasta 16oz	$1.79
1	Olive Oil 500ml	$8.99

Zwischensumme$24.94

Steuer (2%)$0.50

GESAMT$25.44

KARTEVISA ****4021

Member savings applied: $2.35

Supermarktbeleg-Vorlage

Barzahlungsbeleg-Vorlage

← Alle Vorlagen

1	Flag Drop	$2.80
1	Distance 4.7 mi	$11.28
1	Wait Time 6 min	$2.40