61A508 (8-11)
ANNUAL REPORT OF DISTILLED SPIRITS
Commonwealth of Kentucky
IN BONDED WAREHOUSE
DEPARTMENT OF REVENUE
Sheet No. ______ of ______ Sheets
AS OF JANUARY 1, ________
Name and Physical Address of Warehouse
Distilled Spirits in New Cooperage
County ________________________________
Distilled Spirits in Reused Cooperage
Other Than Scotch Whiskey
School District __________________________
Scotch Whiskey
City District ____________________________
Natural Spirits ________ Proof
D.S.P. No. _________________
Fire District ____________________________
New Cooperage
Reused Cooperage
Light Whiskey
Barrels
Barrels
Barrels
PART I
45–50
35–45
45–50
35–45
45–50
35–45
Gallon
Gallon
Gallon
Gallon
Gallon
Gallon
1. 0 to 1
yr. old
2. 1 yr. plus to
2 yrs. old
3. 2 yrs. plus to
3 yrs. old
4. 3 yrs. plus to
4 yrs. old
5. 4 yrs. plus to
5 yrs. old
6. 5 yrs. plus to
6 yrs. old
7. 6 yrs. plus to
7 yrs. old
8. 7 yrs. plus to
8 yrs. old
9. 8 yrs. and
over
TOTAL
PART II
45-50 Gallon
Fair Cash Value
35-45 Gallon
Fair Cash Value
Gin
Vodka
Scotch Whiskey
Other
TOTAL
PART III A, Goods not held for shipment out-of-state
PART III B, Goods held for shipment out-of-state
Estimated Fair Cash
Estimated Fair Cash
Size of Cases
Number of Cases
Size of Cases
Number of Cases
Value Per Case
Value Per Case
TOTAL
TOTAL