Arizona Form 835 - Domestic Farm Winery / Domestic Microbrewery / Domestic Cider Return Of Liquor Sold Page 2

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AZ FORM 835
Schedule B
Tax Free Sales of Vinous and Malt/Cider Liquors During the Month
Check only one box:
Vinous
Malt
Cider
INVOICE
DATE
NO. OF
NO. OF
NAME OF PURCHASER
CITY
STATE
SHIPPED
DATE
NUMBER
GALLONS
LITERS
Total this sheet..........................................................................................................................
Total all continuation sheets .....................................................................................................
Convert liters to gallons: 1 liter = 0.264172 U.S. gallons .........................................................
TOTAL GALLONS THIS MONTH: Enter here and on page 1, line 2a .....................................
Schedule C
Out-of-State Sales of Vinous and Malt/Cider Liquors During the Month
Check only one box:
Vinous
Malt
Cider
INVOICE
DATE
NO. OF
NO. OF
NAME OF PURCHASER
CITY
STATE
SHIPPED
DATE
NUMBER
GALLONS
LITERS
Total this sheet..........................................................................................................................
Total all continuation sheets .....................................................................................................
Convert liters to gallons: 1 liter = 0.264172 U.S. gallons .........................................................
TOTAL GALLONS THIS MONTH: Enter here and on page 1, line 2b .....................................
Schedule D
Sales to Licensed Arizona Wholesalers of Vinous and Malt/Cider Liquors During the Month
Check only one box:
Vinous
Malt
Cider
INVOICE
NAME OF PURCHASER/
DATE
NO. OF
NO. OF
SUPPLIER
CITY
STATE
SHIPPED
DATE
NUMBER
GALLONS
LITERS
Total this sheet..........................................................................................................................
Total all continuation sheets .....................................................................................................
Convert liters to gallons: 1 liter = 0.264172 U.S. gallons .........................................................
TOTAL GALLONS THIS MONTH: Enter here and on page 1, line 2c .....................................
ADOR 14-2049f (2/07)
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