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Distillers Report C-212 - Texas

Distillers Report Form. This is a Texas form and can be used in Alcoholic Beverage Commission Statewide .
 Fillable pdf Last Modified 1/16/2015
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DISTILLER'S REPORT Monthly Report of Distilled Spirits Bottled, Received and Disposed of During the Month/Year of: FORM C-212 (06/14) TABC USE ONLY ENTRY CHECKED **REPORT IS DUE ON OR BEFORE THE 15TH DAY OF THE MONTH FOLLOWING EACH REPORTING PERIOD** TRADE NAME: ADDRESS: CITY: ZIP CODE: PERMIT NUMBER: D PHONE NUMBER: Distilled Spirits Miniature 20-60ml (# of units) Summary of Taxes Due 1. Inventory, Beginning of Month (Line 4 on Prior Monthly Report) 2. Distilled Spirits Bottled (Schedule A) 3. Total (Line 1 + 2) 4. Inventory, End of Month 5. Exemptions (Schedule B) 6. Total (Line 4 + 5) 7. Merchandise Subject to Tax (Line 3 - 6) 8. Tax Rate 9. Amount of Taxes (Line 7 x 8) (gallons) $2.40 $0.05 TABC USE ONLY 10. GROSS TAX DUE (Total of Line 9) 11. LESS 2% (If payment received by due date) 12. LESS AUTHORIZED CREDITS 13. TAX DUE STATE $ $ $ $ AFFIRMATION, Under penalty of perjury, I swear I am an officer or an authorized representative of the above Permittee, and I have examined this report, and confirm it is true, correct, and complete. Signature E-Mail Address Title Date INSTRUCTIONS: Prepare the report in duplicate, mail the original to the T.A.B.C., PO Box 13127, Austin, TX 78711-3127 on or before the 15th month, following the month for which the report is made. Retain one copy for you files for a period of four years. As long as your permit remains active, you must file a report even if no business was conducted. For assistance, please contact the Tax Division at (512) 206-3342 or excise.tax@tabc.state.tx.us. Forms are available on our website at (www.tabc.state.tx.us). Page 1 American LegalNet, Inc. www.FormsWorkFlow.com FORM C-212 (03/10) BULK ALCOHOL RECEIVED (from Nonresident Seller or Texas Distiller ) INVOICE DATE INVOICE NUMBER SUPPLIER'S TRADE NAME CITY STATE GALLONS SCHEDULE A - Finshed Products Bottled TOTAL FINISHED PRODUCTS BOTTLED (to line 2, page 1) GALLONS MINIATURE UNITS NOTE: A separate daily bottling record itemizing total cases bottled, bottles per case and size of containers must be prepared and retained in your files. Bulk alcohol may only be purchased from the holder of a Distiller's permit or Nonresident Seller's permit. All receipts and sales of bulk alcohol must be retained in your files to be verified by a representative of the Commission upon request. SCHEDULE B - Tax Exempt Depletions (Sales to Texas Wholesalers, Exports Out-of-State, and Authorized Destructions ) INVOICE DATE INVOICE NUMBER CUSTOMER NAME CITY STATE GALLONS MINIATURE UNITS TOTAL EXEMPTIONS (To line 5, page 1) * Invoices must be submitted to support each tax exempt entry * Page 2 American LegalNet, Inc. www.FormsWorkFlow.com
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