Dbpr Form Ab&t - Alcoholic Beverage Distributor'S Monthly Report Page 5
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6MONTHLY REPORT DETAILS - BEVERAGE EXCISE TAX
License Name
of
, Florida.
For the month of
, Yr.
Reporting Period
/
/
through
/
/
A SEPARATE PAGE MUST BE COMPLETED FOR EACH TYPE OF REPORT AND TRANSACTION
REPORT TYPE
BEER
IMPORTED
DOMESTIC
LIQUOR
(Check one.)
WINE
WINE
Returns to Stock
Sales to Government
In-State Purchases
TRANSACTION TYPE
Out-of-State Sales
(Check one.)
Out-of-State Purchases
Sales to Passenger Carriers
Sacramental Sales
Sales to Other Florida Distributors
PINTS OR LESS
QUARTS
B
BULK GALLONS
NATURAL
UNDER 17.259%
17.259% OR MORE
CIDER
W
INVOICE
NAME OF SUPPLIER OR
DATE
SPARKLING
NUMBER
CONSIGNEE
UNDER 17.259%
17.259% - 55.78%
L
OVER 55.78%
SUBTOTAL THIS PAGE
TRANSACTION TOTAL
Transfer transaction totals to Summary Page.
DEPARTMENT OF BUSINESS & PROFESSIONAL REGULATION
DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO
DBPR Form AB&T
1940 NORTH MONROE STREET, TALLAHASSEE, FL 32399-1022
4000A-100-3
Revised 11/98
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