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Carriers Report Of Interstate Shipments Of Alcoholic Beverages Destined To Nevada Points LTD 5 - Nevada

Carriers Report Of Interstate Shipments Of Alcoholic Beverages Destined To Nevada Points Form. This is a Nevada form and can be used in Liquor Tax Department Of Taxation Statewide .
 Fillable pdf Last Modified 4/5/2007
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NEVADA DEPARTMENT OF TAXATION LIQUOR TAX DIVISION 1550 E. COLLEGE PARKWAY CARSON CITY NV 89706 CARRIER'S REPORT OF INTERSTATE SHIPMENTS OF ALCOHOLIC BEVERAGES DESTINED TO NEVADA POINTS NEVADA REVISED STATUTE 369.450 Form LTD 5 (1/01) Page .......... of ........... Name of Carrier .................................................................. Address ................................................................................................................ Reporting for month of ........................................., 20 .............. This report must be filed with the Nevada Department of Taxation, Carson City, Nevada on or before the 10 of each month following delivery in Nevada. FREIGHT BILL Delivery Date Number DELIVERED TO CONSIGNEE NEVADA DESTINATION SHIPPER ORIGIN DESCRIPTION OF ALCOHOLIC BEVERAGE No. Pkgs. Type Pkg. Kind th THE UNDERSIGNED HEREBY CERTIFIES THAT THE FOREGOING REPORT IS MADE PURSUANT TO CHAPTER 369 OF NRS, AS AMENDED, AND COVERS THE MONTH SHOWN ABOVE FOR THE COMMON OR CONTRACT CARRIER NAMED IN THIS REPORT AND IS CORRECT TO THE BEST OF THE KNOWLEDGE AND BELIEF OF THE UNDERSIGNED. Dated .........................................., 20 ........., at ................................................................... Signed ................................................................................. Telephone (...........)................................................ American LegalNet, Inc. www.FormsWorkflow.com
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