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Direct Shippers Report C-240 - Texas
| Direct Shippers Report Form. This is a Texas form and can be used in Alcoholic Beverage Commission Statewide . |
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FORM C-240 (01/12) TABC USE ONLY ENTRY TEXAS DIRECT SHIPPER'S REPORT Quarterly Report of Wine Shipped to Ultimate Consumers in Texas **REPORT IS DUE ON OR BEFORE THE 15TH DAY OF THE MONTH FOLLOWING EACH QUARTERLY REPORTING PERIOD** CHECKED TRADE NAME: ADDRESS: CITY: REPORTING PERIOD: STATE: ZIP: PERMIT NUMBER: DS PHONE NUMBER: (Sep-Nov) (Dec-Feb) (Mar-May) CHECK ONE (Jun-Aug) YEAR: GALLONS INVOICE DATE NUMBER CUSTOMER'S NAME CITY WINE 14% AND LESS WINE OVER 14% - 24% WINE SPARKLING TABC PERMITTED CARRIER MAKING DELIVERY 1. TOTAL GALLONS 2. STATE EXCISE TAX RATE 3. TAX DUE PER CLASS (Line 1 x Line 2) $0.204 $0.408 $0.516 *PLEASE NOTE: no more than 9 gallons per month or 36 gallons per 12month period may be shipped to the same consumer. TOTAL TAX DUE STATE (Line 3) $ 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 must be filed on or before the 15th day of the month, following each quarterly reporting period. Mail to TABC, PO BOX 13127, AUSTIN, TX, 787113127. Retain one copy for your files for a period of five years. As long as your permit remains active, you must timely 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-240 (01/12) GALLONS INVOICE DATE NUMBER CUSTOMER'S NAME CITY WINE 14% AND LESS WINE OVER 14% - 24% WINE SPARKLING TABC PERMITTED CARRIER MAKING DELIVERY Page 2 American LegalNet, Inc. www.FormsWorkFlow.com
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