Form R-57 - Beverage Tax - Withdrawals From Bond And Tax Payments Made At Piers

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R-57

(8-97, Rev. 2)

STATE OF NEW JERSEY

SCHEDULE “BW”

DEPARTMENT OF THE TREASURY

DIVISION OF TAXATION

SHEET No. __________ of __________

LICENSEE: _________________________________________________

Months of _____________________ and

BEVERAGE TAX

ADDRESS: _________________________________________________

____________________, year ________

WITHDRAWALS FROM BOND AND TAX PAYMENTS MADE AT PIERS.

LICENSE NO. ___________________________________

(Please See Instruction No. 28)

1. Name and Address of Warehouse

Receiving

Bond

Whse.

Quantity and

Vendor

Bottle Size

Record

* Kind of

2. Name of Ship and Pier

Release

or Entry

Wine Gallons

Kind of

and

and Number

Number

Beverage

3. Appraisers Stores

Number

Package

Brand Name

per Case

& Date

* In column headed “Kind of Beverage”, classify as either Beer, Liquor, Alcohol, Still Wines, Vermouth, Sparkling Wines (including apple cider with more than 7% alcohol) or Apple Cider (with 3.2% to 7% alcohol).