Form Abc-218 - Kansas Distributors' Monthly Report Of Purchases - Continued
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1KANSAS DISTRIBUTORS’ MONTHLY REPORT OF PURCHASES - CONTINUED
Distributor Name: ____________________________________ FEIN: __________________ Month: _______________ Year: _____________
Vendor’s Kansas
Purchase
Purchase
Supplier Permit Number
Product
Order
Order
GTIN/SCC
Selling
Product
Unit of
Received
Received Unit
No.
Code
or Licensed Farm Winery,
UNIMERC
Type
Received
Received
(Optional)
Units
Unit Size
Measure
Quantity
of Measure
Microbrewery or
Number
Date
Manufacturer
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.
P
age ___of ___
ABC-218 (Rev. 7.1.11)
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Parent category: Financial