Form Ltd 4b - Liquor Wholesaler Monthly Report Of Sales To Airlines - Nevada Department Of Taxation

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NEVADA DEPARTMENT OF TAXATION
1550 E COLLEGE PARKWAY
CARSON CITY, NEVADA 89706
LIQUOR WHOLESALER MONTHLY REPORT OF SALES TO AIRLINES (NRS 369.175)
Excise tax credit (as shown on LTD 1) for alcoholic beverages exported from the State of Nevada
to the AIRLINES during the month of
, 20
By the firm of
Street
City
This report must be made monthly to the Department of Taxation for shipments to the airlines.
MALT BEVERAGES
ALCOHOLIC BEVERAGES
BOTTLE
KEG
GALLONS
GALLONS
GALLONS
OR CAN
DATE
NAME OF AIRLINE
14.1% to 22%
22.1% to 80%
GALLONS
.5% to 14 %
GALLONS
GALLON TOTALS:
LESS .5% FORMERLY DISCOUNTED:
:
TOTAL, ENTER ON LINE 4b OF TAX RETURN
The foregoing report is true and correct to the best of my knowledge and belief.
Signed ................................ ................................ ................
Title ................................ ................................ ....................
LTD 4b (10/03)

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