DEPARTMENT OF BUSINESS & PROFESSIONAL REGULATION
DBPR Form AB&T
DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO
4000A-100-4
Revised 11/98
1940 NORTH MONROE STREET, TALLAHASSEE, FL 32399-1022
WHOLESALE DISTRIBUTOR'S SCHEDULE OF LICENSED SALESPERSONS
Submit the ORIGINAL and FIRST COPY to the AUDITING DISTRICT OFFICE of the Division of Alcoholic Beverages and Tobacco with
your monthly report, attached to the DISTRIBUTOR'S MONTHLY WINE (JDBW) or LIQUOR (KLD) report.
License Name
License Number
Address
City
Florida Zip Code
Month Reported
Year
For Period
through
SALESPERSONS TERMINATING THIS MONTH
LICENSE NO.
NAME
DATE
LICENSE NO.
NAME
DATE
NEW SALESPERSONS HIRED THIS MONTH
LICENSE NO.
NAME
DATE
LICENSE NO.
NAME
DATE
SALESPERSONS CONTINUING THIS MONTH
LICENSE NO.
NAME
LICENSE NO.
NAME