Report Of Shipments Of Alcoholic Beverages Into Nevada
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Report Of Shipments Of Alcoholic Beverages Into Nevada Form. This is a Nevada form and can be use in Department Of Taxation Statewide.
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Tags: Report Of Shipments Of Alcoholic Beverages Into Nevada, LTD 04, Nevada Statewide, Department Of Taxation
REPORT OF SHIPMENTS OF ALCOHOLIC BEVERAGES INTO NEVADA
Page ____________ of ____________
TO:
Nevada Department of Taxation
1550 E. College Parkway Rm. 115
Carson City, Nevada 89706
Today’s date
Shipments for
(Month/Year)
FROM:
Certificate of
Compliance Number
(Supplier’s Name)
(Address)
SUBJECT:
(City)
(State)
(Zip)
Alcoholic beverages shipped into Nevada pursuant to Certificate of Compliance (NRS 369.430).
This form must be mailed to the Department no sooner than the end of the month and no later than
the 10th of the following month.
ZERO (NO SHIPMENT REPORTS) ARE NOT REQUIRED.
Nevada Import/Wholesaler Shipped To:
(One Import/Wholesaler Location per Report)
Address Shipped To:
SHIPPING
DATE
INVOICE
NUMBER
TOTAL
CASES
BEER GALLONS
Keg or
Draught
Bottled or
Canned
ALCOHOLIC BEVERAGES
.5% to 14%
GALLONS
14.1% to 22%
GALLONS
22.1% to 80%
GALLONS
TOTALS:
INCLUDE COPIES OF ALL INVOICES WITH EACH REPORT SUBMITTED.
DO NOT USE STAPLES
Reported by
Title or Department
Phone Number (
LTD 04
)
8/03
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