Account Information
Account Number
*
Location Address
*
Business Name
*
New mailing address – if applicable
Gross Liquor Sales
(excludes beer and wines sales)
SELECT MONTH ENDING
*
Gross sales
* (Enter actual amount; Annual maximum will be calculated on the next screen)
Is your business liquor package stores
*
YES
NO
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.
CONTINUE
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