Fillable Form LB41. Convert quanes to barrels (see Form (Minnesota Department of Revenue)

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Form LB41. Convert quanes to barrels (see Form (Minnesota Department of Revenue)

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Manufacturer’s Minnesota Warehouse Report
LB41MW
Brewers and malt-beverage manufacturers that have a manufacturer’s warehouse permit under MS 340A.3055 must le this report monthly with
Form LB41. Convert quanes to barrels (see Form LB41 instrucons).
(Rev. 9/14)
1 Beginning inventory. Enter total barrels of malt beverages in
Minnesota warehouse (line 8 from the previous month) ................... 1
2 Total malt-beverage shipments to Minnesota warehouse (from Schedule A) .....2
3 Returns and other addions to inventory (from Schedule B) ................ 3
4 Total amount available for sale (add lines 1, 2 and 3) ...................... 4
5 Sales to Minnesota wholesalers and other removals from inventory
(from Schedule C) ................................................... 5
6 Sales to wholesalers and agencies out of state (from Schedule D) ............ 6
7 Add lines 5 and 6 .................................................... 7
8 Ending inventory (subtract line 7 from line 4) ............................ 8
Inventory
A B
More Than 3.2% 3.2% or Less
(in barrels) (in barrels)
Authorized Signature Date Dayme Phone
Print Name Title
I declare that this form and accompanying schedules are correct and complete to the best of my knowledge and belief.
Mail to: Minnesota Revenue, Mail Staon 3331, St. Paul, MN 55146-3331
Phone: 651-556-3036 Email: alc.taxes@state.mn.us
Sign Here
Check if Amended
Company Name FEIN
Address Minnesota Tax ID Number Locaon Code
City State ZIP Code Period of Return
Print or Type
List the malt-beverage products shipped during the period to Minnesota warehouses. (Aach addional sheets if necessary.)
Invoice More Than 3.2% 3.2% or Less
Date Rec’d Purchased From
Date Number
(in barrels) (in barrels)
Malt-Beverage Purchases Schedule A
LB41MW
Total
(Enter on Form LB41MW, line 2)
Company Name FEIN
Period of Return Minnesota Tax ID Number Locaon Code
Customer Returns B1
Schedule B Total
(Add totals from B1 and B2. Enter
result on Form LB41MW, line 3)
Returns/Other Addions to Inventory (Aach addional sheets if necessary.) Schedule B
Other Addions to Inventory B2
Total
Total
LB41MW
Invoice More Than 3.2% 3.2% or Less
Date Rec’d Returned From Date Number (in barrels) (in barrels)
Company Name FEIN
Period of Return Minnesota Tax ID Number Locaon Code
More Than 3.2% 3.2% or Less
Date Describe Addion (in barrels) (in barrels)
Sales to Minnesota Wholesalers/Other Removals (Aach addional sheets if necessary.) Schedule C
Sales to Minnesota Wholesalers C1
LB41MW
Date Invoice More Than 3.2% 3.2% or Less
Rec’d Sold to/Locaon Shipped Date Number (in barrels) (in barrels)
Schedule C Total
(Add totals from C1 and C2.
Enter result on Form LB41MW, line 5)
Samples/Promoons C2
Total
Invoice
Date More Than 3.2% 3.2% or Less
Rec’d Locaon Shipped Date Number (in barrels) (in barrels)
Total
Company Name FEIN
Period of Return Minnesota Tax ID Number Locaon Code
Out of State Sales, Reducons and Authorized Breakage/Supervised Destrucon Schedule D
Sales to Wholesalers and Agencies Out of State D1
LB41MW
Invoice
More Than 3.2% 3.2% or Less
Date Sold to/Locaon Shipped Date Number (in barrels) (in barrels)
Total
Schedule D Total
(Add totals from D1, D2 and D3. Enter
result on Form LB41MW, line 6)
Other Reducons D3
Total
Authorized Breakage/Supervised Destrucon D2
Total
Inspector Who More Than 3.2% 3.2% or Less
Date Supervised Destrucon Adavit Number (in barrels) (in barrels)
Company Name FEIN
Period of Return Minnesota Tax ID Number Locaon Code
More Than 3.2% 3.2% or Less
Date Describe Reducon (in barrels) (in barrels)
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Form LB41. Convert quanes to barrels (see Form (Minnesota Department of Revenue)

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Completed 29 July 2020

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