Wine
Invoice Distilled More Than More Than More Than Sparkling Low-Alcohol Bottles Miniatures
Ship Date Shipped to (name and address) Number Spirits 14% or Less 14% to 21% 21% to 24% 24% Wine Cider Dairy (
200 ml or more) (50 ml)
Monthly Informaonal Report
Due by the 10th of the month following the month that shipments were made. Return is due even if no tax is due. If no shipments were made, write “No transacons/shipments.”
If you don’t le on me, there is a $25 penalty for each month the report remains unled.
Recap each invoice before you list it. You may aach mulple pages of this form. Do not send computer printout spreadsheets.
You must convert gallons to liters (1 gallon = 3.7854118 liters; 1 liter = 0.264172 gallons).
LB37
Dislled Spirits and Wine Shipped into Minnesota
(Rev. 6/12)
If addional space is needed, connue on page 2.
Authorized Signature Print Name Title Date Dayme Phone
Paid Preparer’s Signature PTIN Date Dayme Phone
Sign here: I declare that this form is correct and complete to the best of my knowledge and belief.
Mail to:
Minnesota Revenue, Mail Staon 3331, St. Paul, MN 55146-3331
Phone: 651-556-3036 Fax: 651-556-5236 Email: alc.taxes@state.mn.us
Check if Amended
Company Name FEIN
Address Minnesota Tax ID Number Locaon Code
City State ZIP Period of Return
