Form Bt-5a - Schedule A1 - Alcoholic Beverages Tax - In Transit Items Page 2

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FORTIFIED
DISTILLED
STILL WINES
BEER
ALCOHOL AND
LIQUOR COOLERS
Not Over 21% Alcohol
NAME AND ADDRESS
WINES
LIQUOR
COMPONENTS
Not Over
Wine Gallons
Over 21%
INVOICE
of person, firm, or corporation from
DATE
Wine Gallons
for Manufacturing
7% Alcohol
Produced by
Produced by
Alcohol
Convert Draft
All Other
NUMBER
OF
whom alcoholic beverages were
Wineries That
Small Wineries
Proof Gallons
Wine Gallons
and SPARKLING
Size to bbls.
Containers
Are Not Small
PURCHASE
(Producing
purchased during the month listed
WINES
Wineries
Barrels
Wine Gallons
55,000 Wine Gal.
above but that have not been received
Wine Gallons
or less per year)
Form BT-5A, Schedule A1, Back (Rev. 06/01)

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