Form B-1 - Monthly Schedule Of Beer Received From A Source Other Than An Indiana Brewery Or Beer Wholesaler Page 4

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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
88
89
90
91
92
93
94
95
96
97
98
99
Total Beer Gallons ...................................................................................................................
Use one invoice per line.
SUMMARY
1. Enter amount from line 19 .................................................................................................................
1
2. Enter amount from line 53 .................................................................................................................
2
.
3. Enter amount from line 87 .................................................................................................................
3
4. Enter amount from line 99..................................................................................................................
4
5. Add lines 1 through 4 and enter total here. Carry this total over to Form 810, Line 1,
Total Gallons Received .....................................................................................................................
5

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