Maine > Statewide > Liquor Licensing And Inspection Division
Report Of Table Wine Shipments - Maine
| Report Of Table Wine Shipments Form. This is a Maine form and can be used in Liquor Licensing And Inspection Division Statewide . |
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DEPARTMENT OF PUBLIC SAFETY LICENSING & INSPECTION UNIT 164 STATE HOUSE STATION AUGUSTA, ME 04333-0164 REPORT OF TABLE WINE SHIPMENTS 15.5% Alcohol or Less By Holders of a Wine Certificate of Approval Issued by the Department of Public Safety, Liquor Licensing Unit, Authorizing the Sale of Table Wine to Wholesaler Licensees within the State. Month of_________________________________________ 20__________________ Name_____________________________ Address _______________________________ Permit No._____________ Name of Wholesaler Maine Purchase Order Number Invoice Number Invoice Date Total Gallonage Per Invoice Total Gallons Shipped: ______________________ Dated at______________________________,This__________________day of_______________________________________,20 State of_____________________________________ _____________________________________________________ By___________________________________________________ If a corporation report must be signed by duly authorized officer. This record shall be filed with the licensing & Inspection Unit, Augusta, Maine on or before the 10th day of each calendar month. Revised 10/05 American LegalNet, Inc. www.FormsWorkFlow.com
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