Form Com/att-40 - Request For Maryland Release Of Foreign Beer

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COMPTROLLER OF MARYLAND
MATT Regulatory Division /Alcohol and Tobacco Tax
Louis L. Goldstein Treasury Building • P.O. Box 2999 • Annapolis, MD 21404
REQUEST FOR MARYLAND RELEASE OF FOREIGN BEER
Request will not be honored unless this form is completed
Name and address of U.S. Importer
Name and address of Md. Importer
___________________________________________
__________________________________________
___________________________________________
__________________________________________
___________________________________________
__________________________________________
Md. License Number: ________________________
Md. License or Permit No.: ___________________
FOREIGN BEER:
Bottled
Canned
BRAND
NUMBER
CONTAINER SIZE
GALLONS
TOTAL
TAX DUE
(
)
@$.09/G
.
NAME
OF CASES
OUNCES
PER CASE
GALLONS
AL
________________________________________________________________________________________
$
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
TOTAL GALLONS
TOTAL TAX DUE
FOREIGN KEG BEER
BRAND
NUMBER
CONTAINER
GALLONS
TOTAL
TAX DUE
@$.09/G
.
NAME
OF KEGS
SIZE
PER KEG
GALLONS
AL
________________________________________________________________________________________
eigth-barrels
3.875
$
________________________________________________________________________________________
quarter-barrels
7.75
________________________________________________________________________________________
half-barrels
13.20
________________________________________________________________________________________
half-barrels
13.50
________________________________________________________________________________________
half-barrels
15.50
________________________________________________________________________________________
________________________________________________________________________________________
TOTAL GALLONS
TOTAL TAX DUE
TOTAL TAX DUE: ALL FOREIGN BEER – AMOUNT OF CERTIFIED CHECK HEREWITH $
Make checks payable to: Comptroller of Maryland
SEND RELEASE FOR FOREIGN BEER TO:
The foreign beer released will only be shipped
directly to an authorized Maryland Importer.
_____________________________________________
Signature ________________________________
_____________________________________________
U. S. Importer
_____________________________________________
COM/ATT-40 (Rev. 7/07)
PN: 10453

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