The Department of Business and Professional Regulation (DBPR) has created a new form, the DBPR Form AB-T-4000A. The form is to be used by all Florida licensees to report any change in their business name, legal structure, or management. The form must be submitted within 20 days of any change. Failing to submit the form may result in disciplinary action. Licensees should familiarize themselves with the new form and use it when necessary. The DBPR website provides detailed instructions on how to complete and submit the form. If you have any questions, you can contact the DBPR at 850-487-1395. Thank you for your attention to this matter.
| Question | Answer |
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| Form Name | Dbpr Form Ab T 4000A 140 1 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | COMPUTATION, ABT, 1940, form bbpr ab t 40000a 100 1w |
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION |
DBPR Form AB&T |
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DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO |
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Rev. 01/05 |
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1940 NORTH MONROE STREET • TALLAHASSEE, FL |
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WINE MANUFACTURER'S MONTHLY REPORT |
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BULK WINE MANUFACTURED IN FLORIDA |
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IMPORT
DOMESTIC
Prepare in TRIPLICATE. Submit ORIGINAL and FIRST COPY to the AUDITING DISTRICT OFFICE of the DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO. SECOND COPY is to be retained by the licensee. This report and payment must be filed in accordance with the provisions of Chapter 561, Florida Statutes, on or before the tenth day of the month following the month being reported. Make remittances payable to the "Division of Alcoholic Beverages and Tobacco".
Licensee Name |
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Phone No. |
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License No. |
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Address |
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City |
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FL Zip |
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Month Reported |
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20 |
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Reporting Period |
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through |
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This report is true and correct to the best of my knowledge and belief and is submitted under penalty of perjury.
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Typed or Printed Name |
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Authorized Signature |
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COMPUTATION OF TAX |
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1. |
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Gallons |
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$ |
2.25 |
per gallon |
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2. |
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Gallons |
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$ |
3.00 |
per gallon |
$ |
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3. |
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Gallons |
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$ |
3.50 |
per gallon |
$ |
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4. |
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Gallons |
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$ |
0.89 |
per gallon |
$ |
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5. Gross Tax Upon Wine (Lines 1, 2, 3, & 4) |
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$ |
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Less: Discount of 1.9% (Does not apply if Report or Payment is filed late) |
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$ |
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$ |
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Certificate of Credit (if any approved by DAB&T) |
No. |
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$ |
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8. NET AMOUNT EXCISE TAX |
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$ |
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Import 40033 / Domestic 40030 |
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DAB&T USE ONLY |
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Report Receipt |
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In'ls |
Payment Verification |
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In'ls |
Field Review |
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In'ls |
Central Processing |
In'ls |
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Postmark Date |
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Receipt Number |
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Initial Review Date |
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Initial Receipt Date |
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Delivery Date |
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Payment Date |
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Amended Date |
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Completed Date |
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Delinquent Action |
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Excise Tax Paid |
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Amended Amount |
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