Schedule "S" (Form R-25) - Alcoholic Beverage Public Warehouse

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R-25

STATE OF NEW JERSEY

SHEET NO. ________ OF ________

9-97, Rev. 2

DEPARTMENT OF THE TREASURY

DIVISION OF TAXATION

BEVERAGE TAX

REPORT FOR THE BIMONTHLY PERIOD OF

_____________ AND __________, YEAR_________

ALCOHOLIC BEVERAGE PUBLIC WAREHOUSE SCHEDULE “S”

WITHDRAWALS OF ALCOHOL OR ALCOHOLIC BEVERAGES, DELIVERY OF WHICH, AS DECLARED WAS A PLACE WITHIN THE STATE OF NEW JERSEY, MADE DURING THE PERIOD COVERED BY THE REPORT TO WHICH THIS SCHEDULE IS ATTACHED.

From ________________________________________________________

PUBLIC WAREHOUSE LICENSE NO._____________________________________.

(Name of Public Warehouse)

NAME AND ADDRESS OF PERSON

NAME AND ADDRESS OF PERSON FROM

KIND OF PKG.,

NO. OF

RELEASE

LICENSE

WITHDRAWING ALCOHOL OR ALCOHOLIC

WHOSE ACCOUNT THE ALCOHOL OR

*KIND OF

NO. OF

SUCH AS

SIZE OF EACH

DATE OF

CONTAINERS

NUMBER

BEVERAGES; ALSO NAME AND ADDRESS OF

ALCOHOLIC BEVERAGES WERE WITHDRAWN

BEVERAGE

PACKAGES

BBL., CS.,

CONTAINER

NUMBER

WITHDRAWAL

IN EACH PKG.

CONSIGNEE

CTN., ETC.

* 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 (3.2% to 7% alcohol).

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