Form Boe-217 - Common Carrier'S Report Of Delivery
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1
2COMMON CARRIER’S REPORT OF DELIVERY
BOE-217 (FRONT) REV. 7 (10-10)
STATE OF CALIFORNIA
BOARD OF EQUALIZATION
of interstate shipments of alcoholic beverages destined to California points.
Page
_________
of
_________
pages
For Month of
________________________________
Year
_________
IMPORTANT
Name of Common Carrier
_________________________________________________________________________
(Account No.
________________
)
Read instructions on reverse side before
completing report
Mail Address
_____________________________________________________________________________________
BOE USE
R.R. CAR NO.
WAYBILL,
DESCRIPTION
DELIVERY MADE TO
NAME OF SHIPPER
BILL OF LADING
OF ALCOHOLIC BEVERAGES
ONLY
NAME OF VESSEL
NAME OF LICENSED IMPORTER
CITY AND STATE
CODE
AND VOYAGE NO.
OR FREIGHT BILL
NUMBER OF
TYPE
AND CALIFORNIA CITY
PACKAGES
PACKAGES
KIND
NUMBER
OR TRAILER NO.
NUMBER
DATE
A
B
C
D
E
F
G
H
I
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Certified Correct
_____________________________________________
Title
_____________________________________________
PRINT
CLEAR
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