Allowable Credits And Exemptions Form - 1999

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RPD-41159
REV. 5/99
This schedule together with supporting
documents, invoices, etc., must be filed
for all credits taken.
ALLOWABLE CREDITS AND EXEMPTIONS
Exempt Sales
Beer, Cider
Total
Type of Credit
NAME AND ADDRESS OF PERSON OR FIRM
Total
Invoice Information
Spirituous,
Gallons/
or
Tax
Date
Wine
Liters
Exemption
Number
CREDIT AND EXEMPTION CODE

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