Form Com/att-037-5 - Maryland Wholesaler'S Report Of Beer Acquisitions

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Schedule Type
Maryland Wholesaler’s Report of Beer Acquisitions
Comptroller of Maryland
(See the reverse side for complete instructions)
Page
of
MATT Regulatory Division
Alcohol and Tobacco Tax
FOR THE MONTH OF
20
9
Foreign Supplier
WHOLESALER’S NAME:
SUPPLIER
SUPPLIER’S LICENSE OR PERMIT #:
Non-Resident Dealer, Maryland Brewer or Wholesaler
One Supplier Per Page
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
(16)
Number/Cases
Number/Cases
Number/Cases
Number/Cases
Number/Cases
Number/Cases
Invoice
24/7
24/10
24/11.2
24/12
24/16
12/32
¼ Keg
½ Keg
50 L Keg
Number
Date
Carrier
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
Total Cases/Kegs Received
28
Total Gallons
This Supplier
Multiply by Conversion Factor
1.313
1.875
2.100
2.250
3.000
3.000
7.750
15.500
13.210
29
Total Gallons by Container Size
30
COM/ATT-037-5 Rev. 07/07

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