Schedule "F" (Form R-10) - Beverage Tax
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1R-10
(8-97, Rev. 5)
STATE OF NEW JERSEY
Sheet No. _______Of _______
DEPARTMENT OF THE TREASURY
DIVISION OF TAXATION
SCHEDULE “F”
BEVERAGE TAX
Tax Exemption Claimed By___________________________________________________ License No. ______________________________
(Name of Licensee)
during the bimonthly period of _________________________ and _______________________, year __________.
ON THIS SCHEDULE, ENTER THE FOLLOWING:
(A) A list of the Schedule “E” by states, giving the total gallonage for each state (DO NOT INCLUDE the New Jersey Schedule “E”);
(B) All certificates of non-beverage use submitted with the report, for which exemption is claimed;
(C) Each beverage tax credit memo. Enter the combined totals on the control sheet.
Beer and Malt
Liquors
Sparkling
Apple Cider*
Month
(3.2% to 7%
Vermouth
Beverages
(Alcohol)
Still Wines
Wine*
When
Name and Address of Consignee
Alcohol)
Delivered
or State Receiving Delivery
Total Gallons
Total Gallons
Total Gallons
Total Gallons
Total Gallons
Total Gallons
* Apple cider containing more than 7% alcohol to be included under “Sparkling Wines”. Apple cider containing 3.2% to 7% alcohol to be included under
“Apple Cider”.
(Attach Additional Sheets If Necessary)
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