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Texas > Statewide > Alcoholic Beverage Commission

Wholesalers Report C-210 - Texas

Wholesalers Report Form. This is a Texas form and can be used in Alcoholic Beverage Commission Statewide .
 Fillable pdf Last Modified 3/17/2010
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WHOLESALER'S REPORT Monthly Report of Wine and Distilled Spirits Received and Disposed of During the Month/Year of: REG # **REPORT IS DUE ON OR BEFORE THE 15TH DAY OF THE MONTH FOLLOWING EACH REPORTING PERIOD** FORM C-210 (08/05) TABC USE ONLY ENTRY TRADE NAME: ADDRESS: CITY: ZIP CODE: GALLONS PERMIT NUMBER: SUMMARY PHONE NUMBER: UNITS WINE OVER 14% - 24% SPARKLING WINE MINIATURES SUMMARY OF TAXES DUE 1. INVENTORY, BEGINNING OF MONTH (From Line 4 on Prior Monthly Report) 2. LIQUOR RECEIVED (From Line 1, Page 2) 3. TOTAL (Line 1 + 2) 4. INVENTORY, END OF MONTH DISTILLED SPIRITS WINE 14% AND LESS 5. EXEMPTIONS (From Line 2, Page 2) 6. TOTAL (Line 4 + 5) 7. LIQUOR SUBJECT TO TAX (Line 3 - 6) 8. TAX RATES $2.40 $ $0.204 $ $0.408 $ $0.516 $ $0.05 $ 9. AMOUNT OF TAXES (Line 7 x 8) AFFIRMATION, Under penalty of perjury, I swear I am an officer or authorized representative of the above Permittee, and I have examined this report, and confirm it is true, correct, and complete. TABC USE ONLY The following box must be checked if the Permittee did not purchase, sell, or possess Malt Liquor. Otherwise, Form C-233 must be filed. GROSS TAXES DUE (Total of Line 9) $ LESS 2% (If payment is received by due date) $ Signature Title Date LESS AUTHORIZED CREDIT $ (Attach letter of authorization) INSTRUCTIONS: Prepare the report in duplicate, mail the original to the T.A.B.C., PO Box 13127, Austin, TX 787113127. Report must be filed on or before the 15th of day following each reporting period. Retain one copy for your files for a period of four years. As long as your permit remains active, you must file a report even though no business was conducted. For assistance, please contact the Compliance Department at (512) 206-3342. PAGE 1 TAXES DUE STATE $ American LegalNet, Inc. FORM C-210 (08/05) LIQUOR RECEIVED - Schedule A INVOICE DATE INVOICE NUMBER SUPPLIER'S TRADE NAME CITY STATE TOTAL CASES DISTILLED SPIRITS WINE 14% AND LESS GALLONS WINE OVER 14% - 24% SPARKLING WINE UNITS CARRIER MAKING MINIATURES DELIVERY FREIGHT BILL NUMBER 1. TOTAL RECEIVED (To Line 2, Page 1) LIQUOR DISPOSED OF: SALES TO TEXAS WHOLESALERS - Schedule B (Invoices must be submitted to support each entry) SALES TO MILITARY INSTALLATIONS - Schedule C (Retain invoices for audit purposes) EXPORTS OUT-OF-STATE - Schedule D (Invoices must be submitted to support each entry) CARRIER CLAIMS, DESTRUCTION'S AND OTHER ALLOWABLE EXEMPTIONS - Schedule E(Documentation must be submitted to support each entry) 2. TOTAL EXEMPTIONS (To Line 5, Page 1) NOTE: The spaces provided above for Schedules B,C,D and E should reflect monthly totals only. If more than one entry per schedule is needed, attach a supplemental schedule(s). PAGE 2 American LegalNet, Inc. FORM C-210 (08/05) TRADE NAME: FORM C-210 SUPPLEMENTAL SCHEDULE: GALLONS A B C D UNITS E (circle one) INVOICE DATE INVOICE NUMBER VENDOR'S TRADE NAME CITY STATE TOTAL CASES DISTILLED SPIRITS WINE 14% AND LESS WINE OVER 14% - 24% SPARKLING WINE MINIATURES CARRIER MAKING DELIVERY FREIGHT BILL NUMBER TOTAL American LegalNet, Inc.
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