Dbpr Form Ab&t 4000a-100-2 - Monthly Report Summary - Beverage Excise Tax - Department Of Business And Professional Regulation - Florida

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MONTHLY REPORT SUMMARY -- BEVERAGE EXCISE TAX
Reported By
of
FL
For the Month of
20
Reporting Period
through
A separate page must be completed for each type of report and transaction
REPORT TYPE (Choose one)
Beer
Imported Wine
Domestic Wine
Liquor
B
16 OZ OR LESS
>16 OZ TO 32 OZ
BULK GALLONS
17.259% OR
NATURAL
W
UNDER 17.259%
CIDER
MORE
SPARKLING
L
UNDER 17.259%
17.259% - 55.78%
OVER 55.78%
SUMMARY OF PURCHASES
1.
Purchases In-State
2.
Purchases Out-of-State
Total Purchases (Transfer to line 13)
3.
SUMMARY OF DEDUCTIONS
4.
Breakage / Spoilage
5.
Sales To Other Distributors
6.
Returns To Stock -- Tax Paid
7.
Out-of-State Sales
8.
Sacramental Sales*
9.
Sales To Government Stores*
10.
Sales To Passenger Carriers*
11.
Total Deductions (Transfer to line 16)
*Line 8
Attach copy of Sacramental Wine Permit with signed copy of invoice
*Line 9
Attach invoice with Authorized Signature
*Line 10
Attach proper supporting documents
SUMMARY OF TRANSACTIONS
12.
Beginning Inventory
13.
Purchases
14.
Returns To Stock (Tax paid only)
15.
Total To Account For
16.
Deductions
17.
Taxable Sales
18.
Total Accounted For
Ending Inventory
19.
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
DBPR Form AB&T
DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO
4000A-100-2
1940 NORTH MONROE STREET, TALLAHASSEE, FL 32399-1022
Rev. 12/03

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