Form Alc 50015 - Spirits, Wine Or Beer Invoice Schedule (No Brew Pub)

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ALC 50015
Spirits, Wine or Beer Invoice Schedule
Revised 9-2011
(no brew pub)
Oklahoma Tax Commission
2501 North Lincoln Boulevard
Oklahoma City, OK 73194
Check Here if
Taxpayer FEIN/SSN
Month and Year of Report
OTC Permit Number
ABLE Permit Number
Amended Report:
____________________________________________________________________
____________________________________________________________
Firm Name
Contact Person
____________________________________________________________________
____________________________________________________________
Address
Contact Telephone Number
____________________________________________________________________
City
State
Zip
1. OTC Sales
2. OTC Beverage
8. Ship
9. Ship
3. Invoice
4. Invoice
5. Ship To
6. Ship To
7. Ship To
To Zip
Tax Permit
Permit Number
To State
Number
Date
Name
Address
City
16.
10.
12. Unit
13. Unit
14. Sell
15. Alcohol
17. Unit
18. Extended
Product
Transaction
Size
Quantity
Unit
Proof
List Price
List Price
11. Description
Type
Type
I, the undersigned wholesaler, distributor, jobber or duly authorized legal representative thereof do declare under the penalties of perjury that this report, including the accompanying schedules which are made a part thereof, is to the best
of my knowledge and belief true and correct.
Signature: _________________________________________________
Official Title: ___________________________________________
Date: ___________________

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