Direct Shipper Monthly Report
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Direct Shipper Monthly Report Form. This is a New Hampshire form and can be use in Liquor Commission Statewide.
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Tags: Direct Shipper Monthly Report, New Hampshire Statewide, Liquor Commission
State of New Hampshire Liquor Commission
Direct Shipping Monthly Report
Physical Address:
Bureau of Enforcement
Direct Shipping
10 Commercial St
Concord NH 03301
Mailing Address:
Bureau of Enforcement
Direct Shipping
PO Box 1795
Concord NH 03302-1795
Name of Shipper:
Contact Info:
Tel: (603) 271-8543
Fax: (603) 271-3758
directshippers@liquor.state.nh.us
Address:
Permit #
For the Month of
This report must be filed monthly regardless of activity so as to arrive at the New Hampshire Liquor
Commission on or before the 10th of the following month.
Attach to this report a check in the amount of the "Total Amount Due" and copies of all invoices
shipped into NH.
Total # of invoices shipped into NH:
Retail Price including
shipped costs
Retail
Price
Less
shipped costs
Beer
-
=
$0.00
Liquor
-
=
$0.00
Wine
-
=
$0.00
-
$0.00 =
$0.00
Total
$0.00
x .08
Total Fee at 8%
$0.00
*** NH Liquor Commission issued debit/credit memos
Total Amount Due
$0.00
The undersigned hereby swears and affirms that all statements made herein are true and correct to the
best of my knowledge and belief and understand that this statement is made subject to the penalties of
unsworn falsification described in RSA 641:3.
Owner or Officer
*** ( Attach the white copy of the debit/credit memos )
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