Dbpr Form Ab&t 4000a-251-1 - Out Of State Cigarette Manufacturer'S Report

ADVERTISEMENT

DBPR Form AB&T
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
4000a-251-1
DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO
1940 NORTH MONROE STREET • TALLAHASSEE FL 32399-1022
OUT OF STATE CIGARETTE MANUFACTURER'S REPORT
Prepare in TRIPLICATE. Submit ORIGINAL and FIRST COPY to the AUDITING OFFICE of the DIVISION OF ALCOHOLIC BEVERAGES AND
TOBACCO at the address above. SECOND COPY is to be retained by the licensee. This report must be filed in accordance with the provisions of Chapter
210, Florida Statutes, on or before the tenth day of the month following the month being reported.
Name
Phone No. (
)
Permit No.
Address
City
State
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
SUMMARY OF TRANSACTIONS
10's
20's
25's
1.
Sales to Florida Distributors
2.
Returns From Florida Distributors
DAB&T USE ONLY
REPORT RECEIPT
In'ls
AUDIT REVIEW
In'ls
CENTRAL PROCESSING
In'ls
Postmark Date
Initial Review Date
Initial Receipt Date
Delivery Date
Amended Date
Completed Date
Delinquency Action

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal
Go