Form Rv-F1301101 - Price Schedule For Sales Of Alcoholic Beverages For Consumption On The Premises

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TENNESSEE DEPARTMENT OF REVENUE
PRICE SCHEDULE FOR SALES OF ALCOHOLIC BEVERAGES
FOR CONSUMPTION ON THE PREMISES
FIRM REPORTING
ADDRESS
ABC#
STATE
CITY
ZIP CODE
EFFECTIVE DATE
OF
PAGE
INFORMATION TO BE PROVIDED MUST BE ACCURATE. THIS INFORMATION WILL BE USED BY THE DEPART-
MENT OF REVENUE TO VERIFY REPORTED GROSS SALES FOR TAX AUDIT PURPOSES.
SPECIAL SALES PRICES
Quantity
Regular
(List Days & Times)
of
Sales Price
Alcoholic
Including
NAME OF
Beverage
Liquor By
MIXED DRINK
Per Drink
Happy
Other
Other
The Drink
OR WINE
or
Hour
Tax and
Container
Day(s)
Day(s)
Day(s)
Sales Tax
In Ounces
Time(s)
Time(s)
Time(s)
Bar Brands
Call Brands
Premium
Super Premium
Cordials (Liqueurs)
House Wine (Glass)
House Wine (Bottle)
Champagne (Glass)
Champagne (Bottle)
Information contained in this price schedule will be used by the Department of Revenue to verify reported gross sales
through purchase markup audit. Purchase markup audit procedures are described in the Records Reports memorandum
enclosed with this form.
Under penalties of perjury, I declare that I have read and understood this report and that to the best of
my knowledge and belief, the information provided herein is true, correct and complete.
(REPORT MUST BE SIGNED)
This report must be filed upon entering business and when-
SIGN
ever prices or amount of pour changes. Drinks and wine should
HERE
be categorized by price and quantity of alcoholic content. If
SIGNATURE OF PERSON SUBMITTING THIS REPORT
the above categories do not account for a majority of sales,
use additional lines or attach additional sheets.
TITLE
CORPORATE OFFICER , AGENT ETC.
DATE
RV-F1301101 (Rev. 1-08)

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