Form Com/att-037 - Maryland Wholesaler'S Monthly Beer Report
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1
2Comptroller of Maryland
MATT Regulatory Division
Alcohol and Tobacco Tax
P.O. Box 2999
Annapolis, Maryland 21404-2999
410-260-7327/888-784-01145
Maryland Wholesaler’s Monthly Beer Report
Wholesaler Name and Address
Prepare this return in duplicate.
To be filed by all
Use typewriter or print in ink.
wholesalers who are
Retain duplicate.
authorized to sell beer
to retail dealers.
_________________________________________________
Wholesale License Number
This report, setting forth acquisitions of all kegs, cans or other containers of beer, must be filed with the Comptroller of
th
Maryland, Alcohol and Tobacco Tax office, and must be received not later than the 10
day of the month following the
month which this report covers.
For Calendar Month_________________
Summary of Beer Deliveries Received
A
B
C
D
Total Gallons
Total Gallons
Supplier Name:
By Supplier
Supplier Name:
By Supplier
1
13
2
14
3
15
4
16
5
17
6
18
7
19
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20
9
21
10
22
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23
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Statement: I certify that this report, including schedules, has been examined by me and is to the best of my knowledge and belief a
true and complete report for the month stated in accordance with the provisions of the Tax-General Article and Article 2B of the
Annotated Code of Maryland, as amended, title “Alcoholic Beverages”, and regulations issued under authority thereof. I further
certify that I/we will maintain all records including acquisitions and dispositions of alcoholic beverages in accordance with Article
2B.
Signature
Title: Owner, Partner or Officer
Date
COM/ATT-037
Rev. 07/07
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