Form Ab-4-5 - Rectifier'S Report Of Alcoholic Beverages Received From Bottling

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Rev. 3/04

Form AB-4-5

Massachusetts

Rectifier’s Report of

Department of

Alcoholic Beverages Received from Bottling

Revenue

Name of licensee

License number

For month of

This report to be attached to Form AB-1, Alcoholic Beverages Excise Return, to account for alcoholic beverages received from bottling

operations. Net gallonage must be included in the correct schedules of Form AB-1.

Computation

Rectified products bottled (from U.S. Form 2733, Part 3, line 14, column I) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Unrectified products bottled (from U.S. Form 2733, Part 3, line 14, column H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Total received from bottling operations. Add lines 1 and 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

4a Wine and vermouth bottled and included in line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4a

4b Gallonage rebottled and included in line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4b

4c Alcoholic beverages containing 15% or less of alcohol by volume at 60°F (from Form AB-1, Schedule C) . . . . . . . . . . . . 4c

4d Alcoholic beverages more than 50% of alcohol by volume at 60°F (from Form AB-1, Schedule E) . . . . . . . . . . . . . . . . . . 4d

4e Total deductions. Add lines 4a through 4d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4e

Net gallonage received from bottling operations. Subtract line 4e from line 3. Also enter on Form AB-1, Schedule D . . . . . 5

6a Bulk whiskey sold in original package more than 50% of alcohol by volume at 60°F* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6a

6b Bulk whiskey sold in original package 15% or less of alcohol by volume at 60°F* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6b

6c Bulk whiskey sold in original package more than 15% of alcohol by volume at 60°F but not more than 50% of alcohol

by volume at 60°F* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6c

*In reporting gallons in line 6, use wine gallons if 50% or less of alcohol by volume at 60°F, and proof gallons if over 50% of alcohol by volume at 60°F.

List separately.

500 3/04 CRP0104

printed on recycled paper