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Form BOE-243-B Fillable Claim for Distilled Spirits Excise Tax Exemption on Sale or Delivery to Other Licenseesin California
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)(account number) (BOE use only) (business address (street city state and zip code)) (city) (city) (city) (city) (city) (city) (city) (city) (city) (city) (CLEAR) CLEAR (date shipped) (date shipped) (date shipped) (date shipped) (date shipped) (date shipped) (date shipped) (date shipped) (date shipped) (date shipped) (for month of) (invoice amount) (invoice amount) (invoice amount) (invoice amount) (invoice amount) (invoice amount) (invoice amount) (invoice amount) (invoice amount) (invoice amount) (invoice date) (invoice date) (invoice date) (invoice date) (invoice date) (invoice date) (invoice date) (invoice date) (invoice date) (invoice date) (invoice number) (invoice number) (invoice number) (invoice number) (invoice number) (invoice number) (invoice number) (invoice number) (invoice number) (invoice number) (name) (page) (PRINT) CLEAR (reference number) (reference number) (reference number) (reference number) (reference number) (reference number) (reference number) (reference number) (reference number) (reference number) (sold to) (sold to) (sold to) (sold to) (sold to) (sold to) (sold to) (sold to) (sold to) (sold to) (wine gallons 100 proof and under) (wine gallons 100 proof and under) (wine gallons 100 proof and under) (wine gallons 100 proof and under) (wine gallons 100 proof and under) (wine gallons 100 proof and under) (wine gallons 100 proof and under) (wine gallons 100 proof and under) (wine gallons 100 proof and under) (wine gallons 100 proof and under) (wine gallons 100 proof and under) (wine gallons over 100 proof) (wine gallons over 100 proof) (wine gallons over 100 proof) (wine gallons over 100 proof) (wine gallons over 100 proof) (wine gallons over 100 proof) (wine gallons over 100 proof) (wine gallons over 100 proof) (wine gallons over 100 proof) (wine gallons over 100 proof) (wine gallons over 100 proof) (year) 100 ProoF A B C D E F G H I J accordance ACCoUnt nUMBEr AnD UnDEr below Board BoE 243 B (Front) rEV 4 (10 10) STATE OF CALIFORNIA BOE 243 B 4 (10 10) bottom boxes BUSInESS ADDrESS (street city state and zip code) CLAIM FOR DISTILLED SPIRITS EXCISE TAX EXEMPTION ON BOARD OF EQUALIZATION CODE NO COLUMN Columns completed DAtE no AMoUnt Do not write in this column duplicate enter Enter business address including zip code Enter date the distilled spirits were shipped Enter entire account number Enter invoice date covering the shipment Enter invoice number covering the shipment Enter owner or company name Enter page number and number of pages in reporting month Enter purchase order number release number or other referenced number Enter reporting month and year Enter the name of the California city where delivered Enter the name of the California purchaser to whom the distilled spirits were sold Enter total dollar amount of the invoice Enter total gallons of distilled spirits 100 proof or under which were sold Enter total gallons of distilled spirits over 100 proof which were sold entries Equalization Special Taxes and Fees P O Box 942879 Sacramento CA 94279 0088 every files FILINGREQUIREMENTS For Month oF instructions INSTRUCTIONS THECLAIMFORDISTILLED INVOICE WINE GALLONS of Pages or delivery of distilled spirits to another California taxpayer original Please read the instructions on the reverse before preparing this report PREPARATIONOFTHEREPORT Prepare REFERENCE report report retain SALE OR DELIVERYTO OTHER LICENSEES IN CALIFORNIA SALEORDELIVERYTOOTHERLICENSEESINCALIFORNIAREPORT SHIPPED showing SoLD to CItY SPIRITSEXCISETAXEXEMPTIONON State The original of this report must be mailed to the State Board of Equalization Special Taxes and Fees P O Box 942879 Sacramento CA 94279 0088 Total totals Totals from previous page t