Form 69-136 - Texas Distributor Receiving Record Of Cigar And Tobacco Products

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69-136
(9-09)
PRINT FORM
CLEAR FIELDS
b.
TEXAS DISTRIBUTOR RECEIVING RECORD
OF CIGAR AND TOBACCO PRODUCTS – EFFECTIVE 9/1/2009
(Attach this form to your Texas Distributor Monthly Report of Cigar and Tobacco Products, Form 69-133, for the same fi ling period.)
a. Taxpayer number
c. Filing period
Month ending_______________________________
If additional sheets are necessary,
(month / year)
make photocopies of this form or
d. Taxpayer name
download additional copies via the Internet
at
e. Physical address of permitted location - Street
City
State
ZIP Code
CLASS W
CLASS B
CLASS C
CLASS D
CLASS F
SEE CLASS DEFINITIONS ON THE BACK OF THIS FORM.
(Enter volume)
(Enter volume)
(Enter volume)
(Enter volume)
(Enter number)
(Enter weight)
f.
BEGINNING INVENTORY
(Same as Ending Inventory from prior period report.)
ea.
oz.
g.
ENDING INVENTORY
(Actual physical inventory on the last day of the month.)
ea.
oz.
1.
2.
3.
4.
CLASS W
5.
6.
7.
8.
REC.
INVOICE
NAME OF MANUFACTURER,
CLASS B
CLASS C
CLASS D
CLASS F
(Enter volume)
(Enter volume)
(Enter volume)
(Enter volume)
DATE
NUMBER
IMPORTER OR SUPPLIER
(Enter number)
(Enter weight)
h.
GRAND TOTALS FOR THIS PAGE ONLY

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