Page 1 FORM C-231 (0/1)TABC USE ONLYENTRYCHECKED STATE:DATENUMBERBEERALE/MALT LIQUOR INVOICECITY Beer = 4% alcohol by weight or less Ale/Malt Liquor = over 4% alcohol by weight SignatureTitleE-MailDateINSTRUCTIONS:Thisformandanyattachmentsmustbefiledonorbeforethe15thdayofthemonthfollowingeachreportingperiod.MailtoTABC,POBOX13127,AUSTIN,TX78711-3127orsubmitelectronicallytothee-mailaddressbelow.Retainonecopyforyourfilesforaperiodoffouryears.Aslongasyourlicense/permitremainsactive,youmustfileareportevenifnobusinesswasconducted.Totalgallonsofbeerandale/maltliquormustbeincluded on each invoice. For assistance, please contact the Tax Division at (512) 206-3342 or excise.tax@tabc.. TX DISTRIBUTOR / WHOLESALER GALLONS **BRAND SUMMARY REPORT MUST BE INCLUDED WITH THIS FORM. (SEE SUPPLEMENTAL PAGE)** TOTAL AFFIRMATION, Under penalty of perjury, I swear I am an officer or authorized representative of the above Licensee/Permittee, and I have examined this report, and confirm it is true, correct, and complete. ADDRESS: ALE/MALT LIQUOR PERMIT No. S/U CITY:ZIP: NONRESIDENT MALT BEVERAGE REPORTMonthly Report for Beer and Ale/Malt Liquor Shipped into the State of Texas **REPORT IS DUE ON THE 15TH DAY OF THE MONTH FOLLOWING EACH REPORTING PERIOD** BEER LICENSE No. BS REPORTING PERIOD: TRADE NAME: American LegalNet, Inc. www.FormsWorkFlow.com Page 2 FORM C-231 (0/)DATENUMBERBEERMALT LIQUORINVOICETX DISTRIBUTOR / WHOLESALERCITY GALLONS Beer = 4% alcohol by weight or less Ale/Malt Liquor = over 4% alcohol by weight American LegalNet, Inc. www.FormsWorkFlow.com Supplemental Page BRAND NAME(alphabetically)1/2 bbl1/4 bbl1/6 bbl24/1224/16FORM C-231 (0/1)NUMBER OF CASES / KEGSTEXAS ALCOHOLIC BEVERAGE COMMISSIONSUMMARY OF MALT BEVERAGE BRANDS AND PACKAGE SIZES SHIPPED INTO THE STATE OF TEXASBEER OR ALE/MALT LIQUOR TOTAL TRADE NAME: MONTH/YEAR: American LegalNet, Inc. www.FormsWorkFlow.com