Form Abc-303 - Cereal Malt Beverage (Cmb) Stamp Order Form
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1Kansas Department of Revenue
Alcoholic Beverage Control Division
915 S.W. Harrison Street, Room 214
Topeka, KS 66625-3512
Phone: 785-296-7015 Fax: 785-296-7185
ABC.Marketing.Unit@kdor.ks.gov
CEREAL MALT BEVERAGE (CMB) STAMP ORDER FORM
To order State CMB Stamps, please complete and return this form via mail, fax or email.
City/County Clerk Information:
County/City Name:
City/County ID Number:
Name of Person Requesting CMB Stamps:
Title of Person Requesting CMB Stamps:
Mailing Address:
City / State / Zip:
Phone:
Fax:
CMB Order Information:
*Quantity of State CMB Stamps Requested:
_________________________________________________________________________
Signature of Person Requesting State CMB Stamps
Date
ABC Office Use Only:
CMB Stamp Numbers Issued: Starting #
Ending #
Quantity Issued:
Date Issued:
Issued By:
* Order CMB Stamps in multiples of five (5) up to a maximum of 500.
ABC-303 (Rev. 7.1.11)
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