Form Abc-220 - Distributors' Monthly Report Of Sales - Continued
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1DISTRIBUTORS’ MONTHLY REPORT OF SALES - CONTINUED
Distributor Name: ____________________________________ FEIN: __________________ Month: _______________ Year: _____________
Shipment
Product
Buyer’s License /
Invoice
Invoice
GTIN/SCC
Selling
Product
Unit of
Shipment
No.
Code
UNIMERC
Unit of
Unit Price
Type
Permit Number
Number
Date
(Optional)
Units
Unit Size
Measure
Quantity
Measure
I declare under penalties of perjury that to the best of my knowledge and belief this is a true, correct and complete return.
SIGNATURE ____________________________________________ TITLE __________________________________________________
State whether individual owner, member of firm, or title if officer of corporation.
Page 1 of _____
ABC-220 (Rev. 7.1.11)
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