Vermont > Statewide > Department Of Taxes
Statement Of Malt Beverages Sold To Vermont Dealer MB-3 - Vermont
| Statement Of Malt Beverages Sold To Vermont Dealer Form. This is a Vermont form and can be used in Department Of Taxes Statewide . |
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VERMONT DEPARTMENT OF TAXES PO BOX 547 MONTPELIER, VT 05601-0547 STATEMENT OF MALT BEVERAGES SOLD TO A VERMONT DEALER For month of __________________, 20______ File this report on or before the 20th of each month. Distributor Distributor's Address City State ZIP Code VT Dealer (Use a separate sheet for each Vermont dealer.) Address City State ZIP Code Include Transfers and/or Credits to VT Dealers INVOICE Number Date 1/2 KEGS 1/4 13.2 Gals. 12 40 oz. 12 32 oz. 24 16 oz. CASES 24 12 oz. 12 12 oz. 24 7 oz. TOTAL GALLONS TOTALS I declare, under penalties of perjury, that this return (including any accompanying schedules and statements) is true, correct, and complete to the best of my knowledge. Distributor Signature Date Prepared by (Print or Type) Title Rev. 10/07 Form MB-3 American LegalNet, Inc. www.FormsWorkFlow.com
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