Form Wv/wne-01 - West Virginia Wine Supplier'S Report Page 3
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3WV/WNE-01
WEST VIRGINIA WINE SUPPLIER'S REPORT
rtL165V 6 Web
SECTION 2 - NON-REGISTERED SUPPLIER SHIPMENTS
(Liters = Gallons x 3.7854)
WV Suppliers - Report purchases below
SUPPLIER
LOCATION
INVOICE DATE
INVOICE NUMBER
TOTAL LITERS
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Page 3 of 3
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