Free Front.p65 - California

BOE-243-B (FRONT) REV. 3 (8-00)

STATE OF CALIFORNIA

CLAIM FOR DISTILLED SPIRITS EXCISE TAX EXEMPTION ON SALE OR DELIVERY TO OTHER LICENSEES IN CALIFORNIA
Please read the instructions on the reverse before preparing this report.
ACCOUNT NUMBER FOR MONTH OF

BOARD OF EQUALIZATION

Year
NAME

Page

of

Pages

BUSINESS ADDRESS (street, city, state and ZIP code)

INVOICE SOLD TO CITY CODE NO. (Board use only) DATE SHIPPED REFERENCE NO. DATE NO. AMOUNT

WINE GALLONS 100 PROOF AND UNDER OVER 100 PROOF

A Totals from previous page

B

C

D

E

F

G

H


I

J

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
TOTALS

The original of this report must be mailed to the Excise Taxes Division, State Board of Equalization, 450 N Street, MIC:56, PO Box 942879, Sacramento, CA 94279-0056.

BOE-243-B (BACK) REV. 3 (8-00)

INSTRUCTIONS FOR COMPLETING THE CLAIM FOR DISTILLED SPIRITS EXCISE TAX EXEMPTION ON SALE OR DELIVERY TO OTHER LICENSEES IN CALIFORNIA REPORT

FILING REQUIREMENTS This report must be completed in accordance with the instructions below showing each and every sale or delivery of distilled spirits to another California taxpayer.

PREPARATION OF THE REPORT Prepare report in duplicate, retain a copy for your files, and mail the original to the Excise Taxes Division, State Board of Equalization, 450 N Street, MIC:56, PO Box 942879, Sacramento, CA 94279-0056. · · · · · Enter entire account number. Enter reporting month and year. Enter page number and number of pages in reporting month. Enter owner or company name. Enter business address, including zip code.

COLUMN A. B. C. D. E. F. G. H. I. J. K. Enter the name of the California purchaser to whom the distilled spirits were sold. Enter the name of the California city where delivered. Do not write in this column. Enter date the distilled spirits were shipped. Enter purchase order number, release number or other referenced number. Enter invoice date covering the shipment. Enter invoice number covering the shipment. Enter total dollar amount of the invoice. Enter total gallons of distilled spirits 100 proof or under which were sold. Enter total gallons of distilled spirits over 100 proof which were sold. Total all entries made in Columns I and J and enter the totals in the boxes at the bottom of the report.

CLEAR

PRINT