Instate Cigarette Manufacturer'S Detail Report Form

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DBPR Form AB&T
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
4000A-250-3
DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO
1940 NORTH MONROE STREET • TALLAHASSEE FL 32399-1022
INSTATE CIGARETTE MANUFACTURER'S DETAIL REPORT
Permit No.
Name
of
FL
For the Month of
Yr
Reporting Period
through
DETAIL OF TRANSACTIONS
TRANSACTION TYPE (Check one)
Sold to Florida Distributors
Miscellaneous
Sold Out of State
Sold to Military
Sold to Federal Prisons
*Record Florida permit number for sales to Florida distributors
NUMBER OF PACKS
*Florida
Invoice
Permit No.
Name and Address of Consignee
Number
Date
10's
20's
25's
Transaction Total (Transfer total to the proper line on page 1)

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