Idaho Wine Distributors
EFO00099
.
6-19-07
FORM WI 1721
Report of Wine Purchases
Name
Employer I.D. No.
Tax Period
Permit Number
INSTRUCTIONS:
You must list the company name, reporting permit number, invoice date and invoice number of each transaction. You
must report TOTAL GALLONS ONLY below. You may use the worksheet on the back of this form to report the number of packages received
(columns 2 through 19). Convert to gallons and carry the amounts to TOTAL GALLONS, below, for each invoice.
Only distributors complete this form. Wineries do not use this form.
Enter the purchases you have made during the month from manufacturers, importers and other distributors.
For each vendor invoice you must enter the vendor name, reporting permit number (see instructions), the invoice date on the VENDOR'S
INVOICE, the vendor invoice number (DO NOT USE YOUR OWN P.O. OR CHECK NUMBER), and the amount purchased. (Remember - if you
are your OWN importer, insert your own reporting permit number).
If you have more than 19 invoices, carry the total on line 20 forward to the top of the next page. Continue this procedure until you have
reported all purchases. On the last page of WI 1721, the line 20 total will be the accumulated total of all pages of WI 1721.
REPORTING
INVOICE
INVOICE
PERMIT
DATE
TOTAL
NUMBER
NAME
NUMBER
MM/DD/YY
GALLONS
Balance Forward
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IF NOT LAST PAGE, CARRY TOTAL TO NEXT PAGE OF WI 1721.
TOTAL - Add lines 1 through 19.
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IF LAST PAGE, CARRY THIS AMOUNT FORWARD TO FORM WI 1752, Line 2.