Form Mt-53 Schedule E - Beer And Similar Fermented Malt Beverage Page 2

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Page 2 of 2 MT-53 (2/15)
Details of lines 2, 3, and 4, Schedule E
2
Gallons purchased on which New York City alcoholic beverages tax was paid
Name of supplier
Registration number or
Address
Gallons purchased
federal EIN
during the period
Total
(enter here and on line 2 on page 1)
3
Gallons sold outside New York City without New York City alcoholic beverages tax paid
Name of customer
Registration number or
Address
Gallons purchased
federal EIN
during the period
Total
(enter here and on line 3 on page 1)
4
Gallons sold within New York City to other registered beer distributors without New York City alcoholic beverages tax paid
Name of customer
Registration number or
Address
Gallons purchased
federal EIN
during the period
Total
(enter here and on line 4 on page 1)
Attach additional sheets if necessary.

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