Vendor'S Malt Manufacturing Return - Florida Department Of Business & Professional Regulation

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DEPARTMENT OF BUSINESS & PROFESSIONAL REGULATION
DBPR Form AB&T
DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO
4000A-130-1
Revised 11/98
1940 NORTH MONROE STREET, TALLAHASSEE, FL 32399-1022
VENDOR'S MALT MANUFACTURING RETURN
Prepare in TRIPLICATE. Submit ORIGINAL and FIRST COPY to the AUDITING DISTRICT OFFICE of the DIVISION OF ALCOHOLIC BEVERAGES AND
TOBACCO. SECOND COPY is to be retained by the licensee. Compute in Wine Gallons (128 fluid ounces per gallon) to cover a calendar month. This
report and payment must be filed in accordance with the provisions of Chapter 561, Florida Statutes, on or before the tenth day of the month
following the month being reported. Make remittances payable to the "Division of Alcoholic Beverages and Tobacco." Distributors paying $50,000 or
more in excise taxes per year must remit tax payments through electronic funds transfer, as prescribed by Chapter 561.111, Florida Statutes.
License Name
Phone #
License #
Address
City
, Florida, Zip
Month Reported
, Yr.
Reporting Period
/
/
through
/
/
.
This report is true and correct to the best of my knowledge and belief and is submitted under penalty of perjury.
Typed or Printed Name
Authorized Signature
PRODUCTION SUMMARY
BATCH
BATCH
BATCH
NUMBER
BULK GALLONS
NUMBER
BULK GALLONS
NUMBER
BULK GALLONS
TOTAL
INVENTORY SUMMARY
PRODUCED
BULK GALLONS
COMPUTATION OF TAX
BEGINNING INVENTORY
BULK GALLONS PRODUCED
=
PRODUCED ( + )
$
@ $0.48 PER GALLON
=
SALES ( - )
$
CERTIFICATE OF CREDIT
=
BOOK BALANCE
$
=
ENDING INVENTORY
NET AMOUNT TO BE
$
REMITTED WITH REPORT
=
OVER/SHORT
40031
DAB&T USE ONLY
REPORT RECEIPT
In'ls
PAYMENT VERIFICATION
In'ls
FIELD REVIEW
In'ls
CENTRAL PROCESSING
In'ls
Postmark Date
Receipt Number
Initial Review Date
Initial Receipt Date
Delivery Date
Payment Date
Amended Date
Completed Date
Delinquency Action
Excise Tax Paid
Amended Amount

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