Alcoholic Beverage Tax Credit Report
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ALCOHOLIC BEVERAGE TAX CREDIT REPORT
NAME OF LICENSEE: _______________________________________
TYPE OF CREDIT
(T) Transfer
SIGNATURE: ______________________________________________
(R) Return
(B) Breakage
FOR MONTH OF: __________________________________________
(F) Sale to Fed. Inst.
GALLONS
TYPE
NAME OF:
BARRELS
INVOICE
(T)
Supplier
NO.
DATE
(R)
Supplier
HIGH
LOW
(Attach
WINE
CIDER
BEER
(B)
Common Carrier
SPIRITS
SPIRITS
Copy)
(F)
Federal Instrumentality
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Parent category: Financial