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Carriers Report C-220 - Texas

Carriers Report Form. This is a Texas form and can be used in Alcoholic Beverage Commission Statewide .
 Fillable pdf Last Modified 4/12/2011
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CARRIER'S REPORT Monthly Report of Interstate Shipments of Alcoholic Beverages During the Month/Year of: **REPORT IS DUE ON THE 15TH DAY OF THE MONTH FOLLOWING EACH REPORTING PERIOD** FORM C-220 (01/11) TABC USE ONLY ENTRY CHECKED TRADE NAME: ADDRESS: CITY: DATE SHIPPED CONSIGNOR (Shipped From) PERMIT NUMBER: STATE: CITY / STATE ZIP CODE: CONSIGNEE (Shipped To) CITY / STATE PHONE NUMBER: COMMODITY FREIGHT BILL # NUMBER OF PKGS. Liquor, Wine, Ale, Beer DATE DELIVERED 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. Signature E-Mail Address Title Date INSTRUCTIONS: This form and any attachments must be filed on or before the 15th day of each month, following each reporting period. Mail to TABC, PO BOX 13127, AUSTIN, TX 78711-3127 or submit electronically to the e-mail address below. 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 if no business was conducted. For assistance, please contact the Tax Division at (512) 206-3342 or excise.tax@tabc.texas.gov. American LegalNet, Inc. www.FormsWorkFlow.com FORM C-220 (01/11) DATE SHIPPED CONSIGNOR (Shipped From) CITY / STATE CONSIGNEE (Shipped To) CITY / STATE FREIGHT BILL # NUMBER OF PKGS. COMMODITY Liquor, Wine Ale, Beer DATE DELIVERED American LegalNet, Inc. www.FormsWorkFlow.com
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