Gas Station Receipt Template
A pump receipt example showing fuel grade, gallons dispensed and price, plus a convenience-store item β the standard forecourt printout.
Last updated:
SUMMIT FUEL STOP
1200 Ridge Route
Hillcrest, ST 00000
(555) 343-8800
| 1 | Premium 93 β 9.86 gal | $42.30 |
| 1 | Coffee 16oz | $2.19 |
Subtotal$44.49
Tax (6%)$2.67
TOTAL$47.16
CARDVISA ****4021
Pump 07 β Come again!
ROUTE 9 FUEL
900 Highway 9
Crossroads, ST 00000
(555) 052-9090
| 1 | Unleaded 87 β 11.42 gal | $39.85 |
| 1 | Windshield Fluid | $3.99 |
Subtotal$43.84
Tax (6%)$2.63
TOTAL$46.47
CARDVISA ****4021
Pump 04 β Thank you!
Sample receipt β all business names are fictional.
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CASH$60.00
Received with thanks β paid in cash.