Distilled Spirits And Wine Shipped Into Minnesota {LB 37}

LB37 Distilled Spirits and Wine Shipped into Minnesota Monthly Informational 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 transactions/shipments." If you don't file on time, there is a $25 penalty for each month the report remains unfiled. Recap each invoice before you list it. You may attach multiple 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). Company name Address City State Zip FEIN Minnesota tax ID number Period of return Location code Check if amended Ship Date Shipped to (name and address) Invoice Number Distilled Spirits 14% or Less Wine More Than More Than 14% to 21% 21% to 24% More Than 24% Sparkling Wine Cider Low-Alcohol Bottles Miniatures Dairy (200 ml or more) (50 ml) If additional space is needed, continue on page 2. Sign here: I declare that this form is correct and complete to the best of my knowledge and belief. Authorized signature Paid preparer's signature Print name Title PTIN Date Date Daytime phone Daytime phone Mail to: Minnesota Revenue, Mail Station 3331, St. Paul, MN 55146-3331 Phone: 651-556-3036 TTY: 711 Minnesota Relay Fax: 651-556-5236 Email: alc.taxes@state.mn.us (Rev. 6/12) American LegalNet, Inc. www.FormsWorkFlow.com LB37 Company name Period of return FEIN Minnesota tax ID number Location code Ship Date Shipped to (name and address) Invoice Number Distilled Spirits 14% or Less Wine More Than More Than 14% to 21% 21% to 24% More Than 24% Sparkling Wine Cider Low-Alcohol Dairy Bottles Miniatures (200 ml or more) (50 ml) American LegalNet, Inc. www.FormsWorkFlow.com