Direct Shippers Report
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Direct Shippers Report Form. This is a Texas form and can be use in Alcoholic Beverage Commission Statewide.
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Tags: Direct Shippers Report, C-240, Texas Statewide, Alcoholic Beverage Commission
FORM C-240 (09/09)
TABC USE ONLY
ENTRY
DIRECT SHIPPER'S REPORT
CHECKED
Quarterly Report of Wine Shipped to Ultimate Consumers in Texas
**REPORT IS DUE ON OR BEFORE THE 15TH DAY OF THE MONTH FOLLOWING EACH QUARTERLY REPORTING PERIOD**
TRADE NAME:
PERMIT NUMBER:
DS
ADDRESS:
CITY:
STATE:
REPORTING PERIOD:
PHONE NUMBER:
ZIP:
(Sep - Nov)
(Dec - Feb)
(Mar - May)
(Jun - Aug)
YEAR:
CHECK ONE
INVOICE
DATE
NUMBER
CUSTOMER'S NAME
CITY
WINE
GALLONS*
1. TOTAL GALLONS
2. STATE EXCISE TAX RATE
3. TAX DUE STATE (item 1 x item 2)
$0.204
TABC PERMITTED CARRIER
MAKING DELIVERY
*PLEASE NOTE: no more
than 9 gallons per month or
36 gallons per 12-month
period may be shipped to
the same consumer.
AFFIRMATION, Under penalty of perjury, I swear I am an officer or authorized representative of the above Permittee, and I have examined this report,
and confirm it is true, correct, and complete.
Signature
E-Mail Address
Date
INSTRUCTIONS: Prepare the report in duplicate, mail the original to the T.A.B.C., PO Box 13127, Austin, TX 78711-3127 on or before the 15th day of the
month, following each quarterly reporting period. Retain one copy for your files for a period of five years. As long as your permit remains active, you
must timely file a report even if no business was conducted.
For assistance, please contact the Tax Division at (512) 206-3342 or
excise.tax@tabc.state.tx.us. Forms are available on our website at (www.tabc.state.tx.us).
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INVOICE
DATE
NUMBER
CUSTOMER'S NAME
CITY
Page 1
WINE
GALLONS*
TABC PERMITTED CARRIER
MAKING DELIVERY
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