Idaho State Police Alcohol Beverage Control PO Box 700, Meridian, ID 83680-0700 Office: (208) 884-7060 Fax: (208) 884-7096 IDAHO WINE REPORT ___________________________ Report Period Premise Number Z-_________ Month/Year Wine Gallons Pre-Mixed Cocktail Gallons Strong Beer Gallons Beginning Inventory Total Purchases Spoilage Sales/Transfers to In-State Wholesalers Sales/Transfers to Out-of-State Wholesalers Total Sales Ending Inventory Recap of Sales by Category: A. Wine B. Coolers C. Cocktails D. Strong Beer Business Name: _______________________________________ Address: _____________________________________________ City/State/Zip: ________________________________________ Contact Person: _______________________________________ Phone: ______________________________________________ PLEASE MAKE COPIES OF THIS FORM AS NEEDED 2/2008 - Wine Report American LegalNet, Inc. www.FormsWorkflow.com