Form B-1 - Monthly Schedule Of Beer Received From A Source Other Than An Indiana Brewery Or Beer Wholesaler Page 2

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B-1 (Formerly Schedule E-1)
List each invoice of beer shipment from a source other than an Indiana brewery or a licensed Indiana beer wholesaler during the month
for which this report is filed, showing Brewery/Importer, Invoice Number, Date Received and Total Beer Gallons.
Page __________of __________Pages
Invoice Number
No.
Brewery/Importer
Date
Beer Gallons
Received
Per Invoice
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
Total Beer Gallons ...................................................................................................................
53
Use one invoice per line.

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