Wine Mixed Spirit Drink Wholesalers Monthly Report
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Wine Mixed Spirit Drink Wholesalers Monthly Report Form. This is a Michigan form and can be use in Liquor Control Commission Statewide.
Tags: Wine Mixed Spirit Drink Wholesalers Monthly Report, LC 155, Michigan Statewide, Liquor Control Commission
Michigan Department of Licensing and Regulatory Affairs
LIQUOR CONTROL COMMISSION
7150 Harris Drive, P.O. Box 30005 - Lansing, Michigan 48909-7505
WINE/MIXED SPIRIT DRINK WHOLESALERS MONTHLY REPORT
Date Reported (month-year)
Address (street and city):
All wholesalers who receive wine or mixed spirit drinks from an Outstate
WHO MUST FILE:
Seller of Wine, an Outstate Seller of Mixed Spirit Drink, or a Mixed Spirit
1. This report must be filed on or before the 15th day of each month for all sales for the preceding month.
THIS REPORT MUST BE FILED EVEN IF NO TRANSACTIONS HAVE OCCURRED.
2. Enter heading information requested above.
3. Attach copies of all invoices for WINE & MIXED SPIRIT DRINKS received from an Outstate Seller of Wine,
or an Outstate Seller of Mixed Spirit Drink Manufacturer.
YOU MUST SEPARATE THE TWO TYPES OF INVOICES.
PLEASE COMPLETE THE FOLLOWING INFORMATION:
______ Total number of invoices being submitted.
Check here if no Wine transactions this month ________.
Check here if no Mixed Spirit Drink transactions this month _______.
Wine or Mixed Spirit Drinks purchased from a Michigan Wholesaler or a
Michigan Winery do not have to be reported.
Licensees who fail to submit a required report, or who file a false report,
may have their license suspended or revoked.
I declare that the information contained in this report is correct to the best of my knowledge.
Signature of Authorized Agent
LC-155 (Rev. 04/11)
PENALTY: License suspension/revocation
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