Form Lb41mw - Manufacturer'S Minnesota Warehouse Report
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5LB41MW
Manufacturer’s Minnesota Warehouse Report
Brewers and malt-beverage manufacturers that have a manufacturer’s warehouse permit under MS 340A.3055 must file this report monthly
with Form LB41. Convert quantities to barrels (see Form LB41 instructions).
Check if amended
Company name
FEIN
Address
Minnesota tax ID number
Location code
City
State
Zip
Period of return
A
B
More Than 3.2%
3.2% or Less
(in barrels)
(in barrels)
1 Beginning inventory. Enter total barrels of malt beverages in
Minnesota warehouse (line 8 from the previous month) . . . . . . . . . . . . . . . . . 1
2 Total malt-beverage shipments to Minnesota warehouse
. . .2
(from Schedule A)
3 Returns and other additions to inventory (from Schedule B) . . . . . . . . . . . . . . 3
4 Total amount available for sale (add lines 1, 2 and 3) . . . . . . . . . . . . . . . . . . . 4
5 Sales to Minnesota wholesalers and other removals from inventory
(from Schedule C) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
6 Sales to wholesalers and agencies out of state (from Schedule D) . . . . . . . . . 6
7 Add lines 5 and 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
8 Ending inventory (subtract line 7 from line 4) . . . . . . . . . . . . . . . . . . . . . . . . . . 8
I declare that this form and accompanying schedules are correct and complete to the best of my knowledge and belief.
Authorized signature
Date
Daytime phone
Print name
Title
Mail to: Minnesota Revenue, Mail Station 3331, St. Paul, MN 55146-3331
Phone: 651-556-3036 TTY: 711 Minnesota Relay Fax: 651-556-5236 Email: alc.taxes@state.mn.us
(Rev. 2/12)
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