BOE-241-A (FRONT) REV. 2 (2-00)
STATE OF CALIFORNIA
DISTILLED SPIRITS PURCHASED OR RECEIVED FROM OTHER LICENSEES IN CALIFORNIA
Please read the instructions on the reverse before preparing this report.
ACCOUNT NUMBER FOR MONTH OF
BOARD OF EQUALIZATION
BUSINESS ADDRESS (street, city, state and ZIP code)
INVOICE PURCHASED FROM CITY CODE NO. (Board use only) DATE RECEIVED REFERENCE NO. DATE NO. AMOUNT
WINE GALLONS 100 PROOF AND UNDER OVER 100 PROOF
A Totals from previous page
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
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-241-A (BACK) REV. 2 (2-00)
INSTRUCTIONS FOR COMPLETING THE DISTILLED SPIRITS PURCHASED OR RECEIVED FROM OTHER LICENSEES IN CALIFORNIA REPORT
FILING REQUIREMENTS This report must be completed in accordance with the instructions below showing each and every purchase or receipt of distilled spirits from 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 seller from whom the distilled spirits were purchased. Enter the name of the California city where the seller's business is located. Do not write in this column. Enter date the shipment was received. Enter purchase order number, release number or other reference number. Enter invoice date covering the shipment. Enter invoice number covering the shipment. Enter total dollar amount of invoice. Enter total gallons of distilled spirits 100 proof or under per seller's invoice. Enter total gallons of distilled spirits over 100 proof per seller's invoice. Total all entries made in Columns I and J and enter the totals in the boxes at the bottom of the report.