Account Information

Account Number *

Location Address *

Business Name *

New mailing address – if applicable

Gross Liquor Sales (excludes beer and wines sales)

For the month ending

Month year picker
empty
Jan	Feb	2019	2024
Mar	Apr	2020	2025
May	Jun	2021	2026
Jul	Aug	2022	2027
Sep	Oct	2023	2028
Nov	Dec	<	>
Today OK Cancel

Gross sales *

Is your business liquor package stores *

Average ounces per drink poured

Average price per drink sold

Your Contact Information

Name *

Title *

Phone # *

Email Address *

I certify that this return, including the accompanying schedules or statements, has been examined by me and is, to the best of my knowledge and belief, a true and complete return made in good faith for the period stated.