Form Dr 0445 Wholesalers Report Of Liquor And Beer Purchases

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DR 0445 (04/18/07)
Page ____ of _____
COLORADO DEPARTMENT OF REVENUE
EXCISE TAX ACCOUNTING SECTION
WHOLESALERS REPORT OF
1375 SHERMAN ST RM 237
DENVER CO 80261
LIQUOR AND BEER PURCHASES
(303) 205-8211 EXT. 6848
Attach to Form DR 0442
Company Name
Account Number
Period (MM/YY)
Commodity reported on this schedule, (check one only):
❑ Vinous Liquor (liters) ❑ Spirituous Liquors (liters) ❑ Hard Cider (gallons) ❑ Malt Liquor (gallons) ❑ 3.2 Beer (gallons)
INVOICE
GALLONS/LITERS PURCHASED
ACCOUNT
DATE
SUPPLIER'S NAME
NUMBER
NUMBER
T
I
T
N
I
AX
NCLUDED
AX
OT
NCLUDED
Totals, this page ...................................
Grand Totals, last page only
Enter these amounts on line 3 or line 4 of the DR 0442.
In lieu of completing this form, you may submit computer printouts, which must follow the same format.

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