Semi-Annual Reporting Form - Vinous Beverages Shipped To Consumers
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Semi-Annual Reporting Form - Vinous Beverages Shipped To Consumers Form. This is a Vermont form and can be use in Department Of Liquor Control Statewide.
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VERMONT DEPARTMENT OF LIQUOR CONTROL
SEMI-ANNUAL REPORTING FORM – VINOUS BEVERAGES SHIPPED TO CONSUMERS
Company Name:
License No.:
Address:
Date:
Signature:
January through June and July through December reporting dates (due by July 15 and January 15 respectively)
Dates covered
MM/YY –
MM/YY
Names and address of
persons delivered to
Date
purchased
Name of Common Quantity of Each
Carrier Used for
Shipment in
delivery
gallons
Monetary
value of each
shipment
Reason for No
Charge for
shipment
TOTAL AMOUNT OF GALLONS AND VALUE OF ALL SHIPMENTS:________________GALLONS____________VALUE
Please return form to: Vermont Department of Liquor Control, 13 Green Mountain Drive, Montpelier, VT 05602 or fax
802-828-1031, Email to dlc-licensing@state.vt.us
PLEASE NOTE: IF YOU DO NOT HAVE A CHARGE LISTED FOR WINE SHIPPED TO A CONSUMER or RETAILER
PLEASE EXPLAIN THE REASON , (ie. Corked, broken bottle, etc)
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