Az Form 800-20 - Schedule B - Sales To Indian Retailers On The Reservation

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SCHEDULE B
AZ FORM 800-20
Schedule B
Sheet ___ of ___
Sales to Indian Retailers on the Reservation
LEGAL BUSINESS NAME
BUSINESS (OR DBA) NAME
TOBACCO LICENSE NO.
RESERVATION NAME
FOR THE PERIOD OF
to
Please see instructions before completing this form.
(a)
(b)
(c)
(d)
(e)
(f)
Invoice
Invoice
BLUE STAMPS
RED STAMPS
GREEN STAMPS
Registration Number and Name
Date
Number
Packs of 20
Packs of 20
Packs of 20
1 Total by Reservation ...............................................................................................................................
1
2 Balance Forward from Other Reservations ............................................................................................
2
3 GRAND TOTAL OF ALL RESERVATIONS: Add lines 1 and 2 in each column .....................................
3
Page 12
ADOR 11040 (9/13)

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