Form 73a626 - Brewer'S Monthly Report Schedule
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173A626 (2-11)
BREWER’S MONTHLY REPORT SCHEDULE
Commonwealth of Kentucky
DEPARTMENT OF REVENUE
Name and Address
Report for Month
This supplement form is to be used in listing sales and distribution in Kentucky.
(
)
Telephone No. ______________________
List each shipment separately and group by distributor. Return to
of ____________________ , 20____
Department of Revenue, Frankfort, Kentucky 40619.
Invoice
Invoice
Full
1/2
1/4
1/8
Cases
Cases
Cases
Cases
Cases
Cases
Cases
Cases
Cases
Cases
Cases
Cases
Cases
Cases
Others
Purchaser
Address
Date
No.
Bbl.
Bbl.
Bbl.
Bbl.
24-7 oz.
32-7 oz.
36-7 oz.
48-7 oz.
24-8 oz.
36-8 oz.
24-10 oz.
12–12 oz.
24–12 oz.
24–14 oz.
24–16 oz.
12–24 oz.
12–32 oz.
12–40 oz.
Cases
TOTALS
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Parent category: Financial