Dbpr Form Ab&t 4000a-140-3 - Wine Manufacturer'S Monthly Report Detail
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1WINE MANUFACTURER'S MONTHLY REPORT DETAIL
Licensee Name
of
FL
For the month of
20
Reporting Period
through
A separate page must be completed for each type of transaction
TRANSACTION TYPE (Choose one):
Sales to Other Distributors
Received From Other Wine Cellars
Out-of-State Sales
Transfers in Bottling
Invoice
Under
17.259%
Natural
Date
Name and Address
Cider
Number
17.259%
or More
Sparkling
TOTALS
DBPR Form AB&T 4000A-140-3
Rev. 12/03
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