Form Alc 36c - Schedule C

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ALC 36C
Rev. 11/03
P.O. Box 530
Columbus, OH
43216-0530
Schedule C
Name
Address
City
State
ZIP
Interstate wine sales into
for the month of
(State)
(Month/Year)
Report in Gallons, Round to Nearest Hundredth
Invoice
Invoice
Shipped To
Mixed
14%
Cider
Date
Number
14%–21% Vermouth
Sparkling
Beverage
6% or Less
or Less
Total gallonage shown on invoices listed
This form may be reproduced by you as needed.

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