Free 1096.P65 - California

STATE BOARD OF EQUALIZATION BOE-1096 FRONT REV. 2 (11-87)

CUSTOMS BROKER'S REPORT OF TRANSACTIONS
involving interstate shipments of alcoholic beverages in Internal Revenue or Customs Bond.

For Month of Customs Broker Mail Address
BOARD USE NAME OF SHIPPER CITY AND STATE DISPOSITION OF SHIPMENT (SEE INSTRUCTION "B" ON REVERSE) ONLY CODE NUMBER A B 72-10 C D NAME OF CARRIER

19 (Account No. )

Page

of

pages

IMPORTANT Read instructions on reverse side before completing report
WAYBILL, BILL OF LADING OR FREIGHT BILL NUMBER F DATE G DESCRIPTION OF ALCOHOLIC BEVERAGES NUMBER OF TYPE PACKAGES PACKAGES H I

R.R. CAR NO. NAME OF VESSEL AND VOYAGE NO. OR TRAILER NO. E

KIND J

GALLONS K

1
72-10

2
72-10

3
72-10

4

5

72-10

6

72-10

7

72-10

8

72-10

9

72-10

10
CERTIFICATION: If a multiple page report is filed, only page 1 of the report need be certified.

72-10

Certified Correct Title

INSTRUCTIONS FOR COMPILING FORM BOE-1096
Prepare in Duplicate, retain Copy, and mail Original to State Board of Equalization, Department of Business Taxes, P.O. Box 942879, Sacramento, California 94279-0001

A report on this form must be filed on or before the fifteenth day of each month covering transactions in a alcoholic beverages during the preceding calendar month. A report must be filed each month regardless of whether there were any transactions. This report must be completed in each detail in accordance with the following instructions. Shipment Entering California by Common Carrier Column A Enter the name of the shipper and the city and state or country in which the shipment originated. Also, please enter the customs entry type and number in this column. B If shipment is for delivery or use in California, enter name of licensed California importer and California city where located. Show entry type and number. If shipment is for transshipment to a point without California, enter name of consignee, destination, and name of common carrier transporting shipment from California. (Copies of shipping documents must be retained for verification by representatives of the Board.) If shipment entered a foreign trade zone, enter name of person or firm for whom entered and the zone entered. (No. 3 ­ San Francisco) C Do not write in this column ­ it is for the Board use only. D Enter name of Carrier transporting to California. E If the shipment entered California by water, the voyage number and the name of the vessel in which the shipment was transported into California must be shown. If the shipment entered California in a railroad car, the car number of the car in which the shipment was contained must be shown. If the shipment entered California by motor carrier, the truck trailer number must be shown. F&G If the shipment entered California by water, the arrival date of the vessel and the steamship bill of lading number must be shown. If the shipment entered California via railroad, air, or motor carrier, the waybill or freight bill date and number must be shown. H Enter the total number of packages contained in the shipment and the type of packages, i.e., cs., ctn., bbl., drum, etc. I J Enter the type of packages contained in the shipment i.e., cs., ctn., bbl., drum, etc. Enter the kind of alcoholic beverages contained in the shipment, i.e., beer, wine, whiskey, gin, rum, etc. Shipments Entering California from Foreign Trade Zone Column A Enter the name of the person or firm in whose name the merchandise was stored in the zone and the zone from which released. (No. 3 ­ San Francisco) B If the alcoholic beverages are for delivery or use in California, enter name of licensed California importer. Show entry type and number. If the alcoholic beverages are for domestic consumption but are for delivery without California, enter name of consignee, destination, and name of common carrier transporting the alcoholic beverages from California. (Copies of shipping documents must be retained for verification by representatives of the Board.) If shipment entered a foreign trade zone, enter name of person or firm for whom entered and the zone entered. (No. 3 ­ San Francisco) C Do not write in this column ­ it is for Board use only. D Leave Blank. E Enter Lot Number. F&G Enter Release Date and Entry Number.

H Enter the total number and type of packages contained in the release from the foreign trade zone. I J Enter the type of packages, i.e., cs., ctn., bbl., drum, etc. Enter the kind of alcoholic beverages, i.e., beer, champagne, whiskey, gin, rum, etc.

K Enter the number of wine gallons contained in the release.

K Enter the number of wine gallons contained in the shipment. For mixed shipments containing more than one kind of alcoholic beverage, enter the number of gallons of each kind.
BOE-1096 BACK REV. 2 (11-87)

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