Wine Certificate Of Approval Holder Summary Tax Report
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Wine Certificate Of Approval Holder Summary Tax Report Form. This is a Washington form and can be use in Liquor Control Board Statewide.
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Tags: Wine Certificate Of Approval Holder Summary Tax Report, LIQ-778, Washington Statewide, Liquor Control Board
WINE CERTIFICATE OF APPROVAL HOLDER
SUMMARY TAX REPORT
FORM LIQ-778
3000 PACIFIC AVE SE
PO BOX 43085
OLYMPIA WA 98504-3085
E-mail: beerwinetaxes@liq.wa.gov
License Number
(Revised 07-06)
MONTH
License Name
If Revised Report
REPORT IN
Location Address
(check box)
YEAR
LITERS
City, State & Zip
Current licensee lists are available at WLCB website: http://www.liq.wa.gov/publications/WineandBeer.asp
PART 1:
(1) DISTRIBUTOR'S
NON-TAXABLE
(ONE LINE TOTAL PER DISTRIBUTOR AND/OR IMPORTER FOR REPORTING MONTH).
(2)
(3)
OR IMPORTER'S
SOLD TO
WSLCB LICENSE NO. DISTRIBUTORS OR IMPORTERS NAME
Total Liters from all other pages Distributor Shipments (If multiple pages used)
TOTAL LITERS THIS PAGE PLUS TOTAL FROM Line (7)
PART 2:
(4)
(5)
(6)
CIDER
LITERS
CITY
14% AND UNDER
LITERS
OVER 14%
LITERS
TOTAL
LITERS
(7)
(8)
TAXABLE (Shipments for Retailers/Consumers/Samples/Donations)
TOTAL LITERS SHIPPED TO RETAILERS LIQ-778-A Line (7) (9)
TOTAL LITERS SHIPPED DIRECTLY TO CONSUMERS (10)
TOTAL LITERS SHIPPED AS SAMPLES/DONATIONS (11)
TOTAL TAXABLE LITERS (The sum of lines 9,10, & 11) (12)
Tax Rates:
Certified True and Correct Under Penalty of Perjury
Cider X $0.0814 =
(13)
(13)
14% & under X
$0.2292 = (14)
(14)
Over 14% line 12 X
$0.4536 = (15)
(15)
(16)
PENALTIES for late reporting 2% per month of box (16)
Signature
Total Due Current Month
Printed Name
Total Tax Due
(17)
(18)
Prior Refund or Balance Due
Telephone No
WSLCB USE ONLY
(19)
Total Amount Due
Date
(20)
WSLCB USE ONLY
Payee Number
Amount Received $
Amount $
Office Audit
Postmark
LIQ-778 - 20-07/06
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REPORT OF SALES TO WASHINGTON
RETAILERS SUMMARY TAX REPORT
FORM LIQ-778-A
3000 PACIFIC AVE SE
PO BOX 43085
OLYMPIA WA 98504-3085
E-mail: beerwinetaxes@liq.wa.gov
License Number
License Name
(07-06)
MONTH
If Revised Report
REPORT IN
Location Address
(check box)
YEAR
LITERS
City, State & Zip
ONE LINE TOTAL PER RETAILER FOR REPORTING MONTH.
Note: If you have sales to Washington Retailers, attach a copy of this report to LIQ-778
(1)
Retailer's
WSLCB LICENSE NO.
(2)
SHIPPED TO
RETAILER'S NAME
(3)
CIDER
LITERS
CITY
(4)
14% AND UNDER
LITERS
(5)
OVER 14%
LITERS
(6)
TOTAL
LITERS
Total Liters from all other pages (If multiple pages used) (7)
TOTAL LITERS THIS PAGE PLUS TOTAL FROM Line (7)
LIQ-778A - 20-07/06
(8)
American LegalNet, Inc.
www.FormsWorkFlow.com
