FORM C-205 (08/18)
TABC USE ONLY
ENTRY
CHECKED
UNITS
WINE 14% WINE WINE DISTILLED DISTILLED
DATE NUMBER AND LESS OVER 14% SPARKLING SPIRITS MINI's (20-60ml)
Title Date
AFFIRMATION, Under penalty of perjury, I swear I am an officer or authorized representative of the above Permittee, and I have examined this report, and confirm it is true, correct, and
complete.
INSTRUCTIONS: This form and any attachments must be filed on or before the 15th day of the month following each reporting period. Mail to TABC, PO BOX 13127, AUSTIN,
TX 78711-3127 or submit electronically to the e-mail address below. Retain one copy for your files for a period of four years. As long as your permit remains active, you must
file a report even if no business was conducted. For assistance, please contact the Tax Division at (512) 206-3342 or excise.tax@tabc.texas.gov.
NONRESIDENT SELLER'S REPORT
Monthly Report of Wine and Distilled Spirits Shipped into the State of Texas
During the Month/Year of:
INVOICE
TRADE NAME:
PERMIT NUMBER:
**REPORT IS DUE ON THE 15TH DAY OF THE MONTH FOLLOWING EACH REPORTING PERIOD**