Dbpr Form Ab&t 4000a-135-2 - Beer Manufacturer'S Monthly Report Page 3
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3BEER MANUFACTURER'S MONTHLY REPORT DETAIL
Licensee Name
of
FL
For the month of
20
Reporting Period
through
A Separate Page Must Be Completed for Each Type of Transaction
Choose one:
Received From Other Breweries
Sales to Other Wholesalers in State
Shipped to Commercial Labs
Returns to Stock - Brewed in Plant
Sales Out of State
Shipped to Container Companies
Exported
Returns to Stock - Brewed by Others
Certified Breakage/Spoilage
Received for lab Analysis
Shipped to Other Breweries - Lab
Date
Invoice Number
Name and Address
16 Oz or Less
> 16 Oz to 32 Oz
Bulk Gallons
TOTALS
DBPR Form AB&T 4000A-135-3
Rev. 12/03
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