*DF0117019999*DF0117019999

FORM 1074STATE OF DELAWARE

DIVISION OF REVENUERESIDENT WHOLESALE DEALER’S

MONTHLY REPORT OFCIGARETTE AND CIGARETTE TAX STAMPS

NAME:

ADDRESS:

CITY:

STATE: ZIP CODE:

TELEPHONE

FAX NUMBER:

NO NON-PARTICIPATING MANUFACTURERE PRODUCTS SOLD INTO DELAWARE NO IF YES, COMPLETE SCHEDULE NPM

PACKAGES OF CIGARETTES

SCHEDULE CIGARETTE ACCOUNT 20’S 25’S TOTAL ON HAND AT BEGINNING OF MONTH (STAMPED) ON HAND AT BEGINNING OF MONTH (UNSTAMPED1074-A RECEIVED FROM MANUFACTURERS (STAMPED)1074-B RECEIVED FROM MANUFACTURERS (UNSTAMPED)1074-C RECEIVED FROM OTHER THAN MNFR (STAMPED)1074-B RECEIVED FROM OTHER THAN MNFR (UNSTAMPED) SOLD IN DELAWARE1074-C SOLD TO DELAWARE AFFIXING AGENTS1074-D SOLD OUTSIDE DELAWARE1074-E SOLD TO EXEMPT ORGANIZATIONS IN DELAWARENPM PRODUCTS PUCHASED FROM NPM DESTROYED, LOST OR STOLEN (STAMPED) DESTROYED, LOST OR STOLEN (UNSTAMPED) RETURNED TO MANUFACTURERS (STAMPED) RETURNED TO MANUFACTURERS (UNSTAMPED) INVENTORY AT END OF MONTH (STAMPED) INVENTORY AT END OF MONTH (UNSTAMPED) STAMP ACCOUNT STAMPS $2.10 $2.63 ON HAND BEGINNING OF MONTH (UNAFFIXED) RECEIVED FROM DOR DURING MONTH SUBTOTAL STAMPS AFFIXED DURING MONTH ( ) ( ) ON HAND AT END OF MONTH (UNAFFIXED) AFFIDAVIT: I hereby swear under penalty of perjury that the foregoing return has been examined by me and that all information contained herein, including any accompanying schedules or statements, is true and correct; and that this constitutes as a complete return for the month slated, pursuant to law, i also swear that the licensee is in compliance with the UNFAIR CIGARETTE SALE ACT, Chapter 26 of Title 6 of the Delaware Code.

SIGNATURE OF LICENSEE OR OFFICER THEREOF TITLE DATE

REPORT FOR THE MONTH OF MM YY

EMPLOYER IDENTIFICATION NUMBER:

OR SOCIAL SECURITY NUMBER:

THIS REPORT AND SCHEDULES 1074A, 1074B,1074C, 1074D, 1074E AND NPM-CIGARE TO BE FILED WITH THEDELAWARE DIVISION OF REVENUE,P.O. BOX 2340, WILMINGTON, DE 19899, ON OR BEFORE THE 20TH DAY OF EACHMONTH FOR THE PRECEDING MONTH,BY EVERY WHOLESALER IN DELAWARE.WHOLESALE DEALERS WHO HAVE A DELAWARE PERMIT BUT WHO ARE SITUATEDOUTSIDE DELAWARE MUST FILE MONTHLYREPORTS ON FORM 1075

(Revised 08/2017)

FOR OFFICE USE ONLY REVENUE CODE: 0035-02

For taxable periods after 8/31/2017

*DF0117029999*DF0117029999

REPORT FOR THE MONTH OF MM YY

EMPLOYER IDENTIFICATION NUMBER:

OR SOCIAL SECURITY NUMBER:

STATE OF DELAWAREDIVISION OF REVENUE

FORM 1074-ARESIDENT WHOLESALER

CIGARETTES RECEIVED FROM MANUFACTURERS

NAME

INVOICENUMBER

DATERECEIVED

DELIVERY CARRIER

STAMPED UNSTAMPED

20’S 25’S 20’S 25’SNAME AND ADDRESS OF MANUFACTURER

TOTAL

(Revised 08/2017)

*DF0117039999*DF0117039999

REPORT FOR THE MONTH OF MM YY

EMPLOYER IDENTIFICATION NUMBER:

OR SOCIAL SECURITY NUMBER:

STATE OF DELAWAREDIVISION OF REVENUE

FORM 1074-BRESIDENT WHOLESALER

CIGARETTES RECEIVED FROM OTHER THAN MANUFACTURER

NAME

STAMPED UNSTAMPED

20’S 25’S 20’S 25’SDATE NAME AND ADDRESS

TOTAL

(Revised 08/2017)

*DF0117049999*DF0117049999

REPORT FOR THE MONTH OF MM YY

EMPLOYER IDENTIFICATION NUMBER:

OR SOCIAL SECURITY NUMBER:

STATE OF DELAWAREDIVISION OF REVENUE

FORM 1074-CRESIDENT WHOLESALER

CIGARETTES SOLD TO DELAWARE AFFIXING ANGENTS

NAME

20’S 25’S 20’S 25’S

STAMPED UNSTAMPED

DATE NAME AND ADDRESS

TOTAL

(Revised 08/2017)

*DF0117059999*DF0117059999

REPORT FOR THE MONTH OF MM YY

EMPLOYER IDENTIFICATION NUMBER:

OR SOCIAL SECURITY NUMBER:

STATE OF DELAWAREDIVISION OF REVENUE

FORM 1074-DRESIDENT WHOLESALER

CIGARETTES SOLD OUTSIDE DELAWARE

NAME

DATE NAME AND ADDRESS

TOTAL

20’S 25’S TOTAL

(Revised 08/2017)

*DF0117069999*DF0117069999

REPORT FOR THE MONTH OF MM YY

EMPLOYER IDENTIFICATION NUMBER:

OR SOCIAL SECURITY NUMBER:

STATE OF DELAWAREDIVISION OF REVENUE

FORM 1074-ERESIDENT WHOLESALER

CIGARETTES SOLD TO EXEMPT ORGANIZATIONS

NAME

DATE NAME AND ADDRESS

TOTAL

20’S 25’S

(Revised 08/2017)

*DF0117079999*DF0117079999

REPORT FOR THE MONTH OF MM YY

EMPLOYER IDENTIFICATION NUMBER:

OR SOCIAL SECURITY NUMBER:

STATE OF DELAWAREDIVISION OF REVENUE

SCHEDULE NPMCIGARETTE SALES OF

NON-PARTICIPATING MANUFACTURER BRANDS

BUSINESS NAME & ADDRESS:

CONTACT PERSON:

TELEPHONE NUMBER:

NUMBER OFCIGARETTE

PACKS SOLDBRAND NAMEOUNCESOF RYO

NON-PARTICIPATINGMANUFACTURER

NAME & ADDRESS

NAME & ADDRESSOF THE PERSON(S)

FROM WHOM EACH BRANDWAS PURCHASED

NAME & ADDRESSOF THE FIRST IMPORTER

OF FOREIGNMANUFACTURED BRANDS20’S 25’S

I certify that the above stated information is true and correct. SIGNATURE DATE

(Revised 08/2017)

ADDRESS: CITY: STATE ZIP CODE: TELEPHONE: FAX NUMBER: 20SON HAND AT BEGINNING OF MONTH STAMPED: 25SON HAND AT BEGINNING OF MONTH STAMPED: TOTALON HAND AT BEGINNING OF MONTH STAMPED: 20SON HAND AT BEGINNING OF MONTH UNSTAMPED: 25SON HAND AT BEGINNING OF MONTH UNSTAMPED: TOTALON HAND AT BEGINNING OF MONTH UNSTAMPED: 20SRECEIVED FROM MANUFACTURERS STAMPED: 25SRECEIVED FROM MANUFACTURERS STAMPED: TOTALRECEIVED FROM MANUFACTURERS STAMPED: 20SRECEIVED FROM MANUFACTURERS UNSTAMPED: 25SRECEIVED FROM MANUFACTURERS UNSTAMPED: TOTALRECEIVED FROM MANUFACTURERS UNSTAMPED: 20SRECEIVED FROM OTHER THAN MNFR STAMPED: 25SRECEIVED FROM OTHER THAN MNFR STAMPED: TOTALRECEIVED FROM OTHER THAN MNFR STAMPED: 20SRECEIVED FROM OTHER THAN MNFR UNSTAMPED: 25SRECEIVED FROM OTHER THAN MNFR UNSTAMPED: TOTALRECEIVED FROM OTHER THAN MNFR UNSTAMPED: 20SSOLD IN DELAWARE: 25SSOLD IN DELAWARE: TOTALSOLD IN DELAWARE: 20SSOLD TO DELAWARE AFFIXING AGENTS: 25SSOLD TO DELAWARE AFFIXING AGENTS: TOTALSOLD TO DELAWARE AFFIXING AGENTS: 20SSOLD OUTSIDE DELAWARE: 25SSOLD OUTSIDE DELAWARE: TOTALSOLD OUTSIDE DELAWARE: 20SSOLD TO EXEMPT ORGANIZATIONS IN DELAWARE: 25SSOLD TO EXEMPT ORGANIZATIONS IN DELAWARE: TOTALSOLD TO EXEMPT ORGANIZATIONS IN DELAWARE: 20SPRODUCTS PUCHASED FROM NPM: 25SPRODUCTS PUCHASED FROM NPM: TOTALPRODUCTS PUCHASED FROM NPM: 20SDESTROYED LOST OR STOLEN STAMPED: 25SDESTROYED LOST OR STOLEN STAMPED: TOTALDESTROYED LOST OR STOLEN STAMPED: 20SDESTROYED LOST OR STOLEN UNSTAMPED: 25SDESTROYED LOST OR STOLEN UNSTAMPED: TOTALDESTROYED LOST OR STOLEN UNSTAMPED: 20SRETURNED TO MANUFACTURERS STAMPED: 25SRETURNED TO MANUFACTURERS STAMPED: TOTALRETURNED TO MANUFACTURERS STAMPED: 20SRETURNED TO MANUFACTURERS UNSTAMPED: 25SRETURNED TO MANUFACTURERS UNSTAMPED: TOTALRETURNED TO MANUFACTURERS UNSTAMPED: 20SINVENTORY AT END OF MONTH STAMPED: 25SINVENTORY AT END OF MONTH STAMPED: TOTALINVENTORY AT END OF MONTH STAMPED: 20SINVENTORY AT END OF MONTH UNSTAMPED: 25SINVENTORY AT END OF MONTH UNSTAMPED: TOTALINVENTORY AT END OF MONTH UNSTAMPED: STAMP ACCOUNTRow1: 210ON HAND BEGINNING OF MONTH UNAFFIXED: 263ON HAND BEGINNING OF MONTH UNAFFIXED: 210RECEIVED FROM DOR DURING MONTH: 263RECEIVED FROM DOR DURING MONTH: 210SUBTOTAL: 263SUBTOTAL: ON HAND AT END OF MONTH UNAFFIXED: ON HAND AT END OF MONTH UNAFFIXED_2: TITLE: DATE: DATE RECEIVEDRow1: INVOICE NUMBERRow1: DELIVERY CARRIERRow1: NAME AND ADDRESS OF MANUFACTURERRow1: 20SRow1: 25SRow1: 20SRow1_2: 25SRow1_2: DATE RECEIVEDRow2: INVOICE NUMBERRow2: DELIVERY CARRIERRow2: NAME AND ADDRESS OF MANUFACTURERRow2: 20SRow2: 25SRow2: 20SRow2_2: 25SRow2_2: DATE RECEIVEDRow3: INVOICE NUMBERRow3: DELIVERY CARRIERRow3: NAME AND ADDRESS OF MANUFACTURERRow3: 20SRow3: 25SRow3: 20SRow3_2: 25SRow3_2: DATE RECEIVEDRow4: INVOICE NUMBERRow4: DELIVERY CARRIERRow4: NAME AND ADDRESS OF MANUFACTURERRow4: 20SRow4: 25SRow4: 20SRow4_2: 25SRow4_2: DATE RECEIVEDRow5: INVOICE NUMBERRow5: DELIVERY CARRIERRow5: NAME AND ADDRESS OF MANUFACTURERRow5: 20SRow5: 25SRow5: 20SRow5_2: 25SRow5_2: DATE RECEIVEDRow6: INVOICE NUMBERRow6: DELIVERY CARRIERRow6: NAME AND ADDRESS OF MANUFACTURERRow6: 20SRow6: 25SRow6: 20SRow6_2: 25SRow6_2: DATE RECEIVEDRow7: INVOICE NUMBERRow7: DELIVERY CARRIERRow7: NAME AND ADDRESS OF MANUFACTURERRow7: 20SRow7: 25SRow7: 20SRow7_2: 25SRow7_2: DATE RECEIVEDRow8: INVOICE NUMBERRow8: DELIVERY CARRIERRow8: NAME AND ADDRESS OF MANUFACTURERRow8: 20SRow8: 25SRow8: 20SRow8_2: 25SRow8_2: DATE RECEIVEDRow9: INVOICE NUMBERRow9: DELIVERY CARRIERRow9: NAME AND ADDRESS OF MANUFACTURERRow9: 20SRow9: 25SRow9: 20SRow9_2: 25SRow9_2: DATE RECEIVEDRow10: INVOICE NUMBERRow10: DELIVERY CARRIERRow10: NAME AND ADDRESS OF MANUFACTURERRow10: 20SRow10: 25SRow10: 20SRow10_2: 25SRow10_2: DATE RECEIVEDRow11: INVOICE NUMBERRow11: DELIVERY CARRIERRow11: NAME AND ADDRESS OF MANUFACTURERRow11: 20SRow11: 25SRow11: 20SRow11_2: 25SRow11_2: DATE RECEIVEDRow12: INVOICE NUMBERRow12: DELIVERY CARRIERRow12: NAME AND ADDRESS OF MANUFACTURERRow12: 20SRow12: 25SRow12: 20SRow12_2: 25SRow12_2: DATE RECEIVEDRow13: INVOICE NUMBERRow13: DELIVERY CARRIERRow13: NAME AND ADDRESS OF MANUFACTURERRow13: 20SRow13: 25SRow13: 20SRow13_2: 25SRow13_2: DATE RECEIVEDRow14: INVOICE NUMBERRow14: DELIVERY CARRIERRow14: NAME AND ADDRESS OF MANUFACTURERRow14: 20SRow14: 25SRow14: 20SRow14_2: 25SRow14_2: 20STOTAL: 25STOTAL: 20STOTAL_2: 25STOTAL_2: DATERow1: NAME AND ADDRESSRow1: 20SRow1_3: 25SRow1_3: 20SRow1_4: 25SRow1_4: DATERow2: NAME AND ADDRESSRow2: 20SRow2_3: 25SRow2_3: 20SRow2_4: 25SRow2_4: DATERow3: NAME AND ADDRESSRow3: 20SRow3_3: 25SRow3_3: 20SRow3_4: 25SRow3_4: DATERow4: NAME AND ADDRESSRow4: 20SRow4_3: 25SRow4_3: 20SRow4_4: 25SRow4_4: DATERow5: NAME AND ADDRESSRow5: 20SRow5_3: 25SRow5_3: 20SRow5_4: 25SRow5_4: DATERow6: NAME AND ADDRESSRow6: 20SRow6_3: 25SRow6_3: 20SRow6_4: 25SRow6_4: DATERow7: NAME AND ADDRESSRow7: 20SRow7_3: 25SRow7_3: 20SRow7_4: 25SRow7_4: DATERow8: NAME AND ADDRESSRow8: 20SRow8_3: 25SRow8_3: 20SRow8_4: 25SRow8_4: DATERow9: NAME AND ADDRESSRow9: 20SRow9_3: 25SRow9_3: 20SRow9_4: 25SRow9_4: DATERow10: NAME AND ADDRESSRow10: 20SRow10_3: 25SRow10_3: 20SRow10_4: 25SRow10_4: DATERow11: NAME AND ADDRESSRow11: 20SRow11_3: 25SRow11_3: 20SRow11_4: 25SRow11_4: DATERow12: NAME AND ADDRESSRow12: 20SRow12_3: 25SRow12_3: 20SRow12_4: 25SRow12_4: DATERow13: NAME AND ADDRESSRow13: 20SRow13_3: 25SRow13_3: 20SRow13_4: 25SRow13_4: DATERow14: NAME AND ADDRESSRow14: 20SRow14_3: 25SRow14_3: 20SRow14_4: 25SRow14_4: 20STOTAL_3: 25STOTAL_3: 20STOTAL_4: 25STOTAL_4: DATERow1_2: NAME AND ADDRESSRow1_2: 20SRow1_5: 25SRow1_5: 20SRow1_6: 25SRow1_6: DATERow2_2: NAME AND ADDRESSRow2_2: 20SRow2_5: 25SRow2_5: 20SRow2_6: 25SRow2_6: DATERow3_2: NAME AND ADDRESSRow3_2: 20SRow3_5: 25SRow3_5: 20SRow3_6: 25SRow3_6: DATERow4_2: NAME AND ADDRESSRow4_2: 20SRow4_5: 25SRow4_5: 20SRow4_6: 25SRow4_6: DATERow5_2: NAME AND ADDRESSRow5_2: 20SRow5_5: 25SRow5_5: 20SRow5_6: 25SRow5_6: DATERow6_2: NAME AND ADDRESSRow6_2: 20SRow6_5: 25SRow6_5: 20SRow6_6: 25SRow6_6: DATERow7_2: NAME AND ADDRESSRow7_2: 20SRow7_5: 25SRow7_5: 20SRow7_6: 25SRow7_6: DATERow8_2: NAME AND ADDRESSRow8_2: 20SRow8_5: 25SRow8_5: 20SRow8_6: 25SRow8_6: DATERow9_2: NAME AND ADDRESSRow9_2: 20SRow9_5: 25SRow9_5: 20SRow9_6: 25SRow9_6: DATERow10_2: NAME AND ADDRESSRow10_2: 20SRow10_5: 25SRow10_5: 20SRow10_6: 25SRow10_6: DATERow11_2: NAME AND ADDRESSRow11_2: 20SRow11_5: 25SRow11_5: 20SRow11_6: 25SRow11_6: DATERow12_2: NAME AND ADDRESSRow12_2: 20SRow12_5: 25SRow12_5: 20SRow12_6: 25SRow12_6: DATERow13_2: NAME AND ADDRESSRow13_2: 20SRow13_5: 25SRow13_5: 20SRow13_6: 25SRow13_6: DATERow14_2: NAME AND ADDRESSRow14_2: 20SRow14_5: 25SRow14_5: 20SRow14_6: 25SRow14_6: 20STOTAL_5: 25STOTAL_5: 20STOTAL_6: 25STOTAL_6: DATERow1_3: NAME AND ADDRESSRow1_3: 20SRow1_7: 25SRow1_7: TOTALRow1: DATERow2_3: NAME AND ADDRESSRow2_3: 20SRow2_7: 25SRow2_7: TOTALRow2: DATERow3_3: NAME AND ADDRESSRow3_3: 20SRow3_7: 25SRow3_7: TOTALRow3: DATERow4_3: NAME AND ADDRESSRow4_3: 20SRow4_7: 25SRow4_7: TOTALRow4: DATERow5_3: NAME AND ADDRESSRow5_3: 20SRow5_7: 25SRow5_7: TOTALRow5: DATERow6_3: NAME AND ADDRESSRow6_3: 20SRow6_7: 25SRow6_7: TOTALRow6: DATERow7_3: NAME AND ADDRESSRow7_3: 20SRow7_7: 25SRow7_7: TOTALRow7: DATERow8_3: NAME AND ADDRESSRow8_3: 20SRow8_7: 25SRow8_7: TOTALRow8: DATERow9_3: NAME AND ADDRESSRow9_3: 20SRow9_7: 25SRow9_7: TOTALRow9: DATERow10_3: NAME AND ADDRESSRow10_3: 20SRow10_7: 25SRow10_7: TOTALRow10: DATERow11_3: NAME AND ADDRESSRow11_3: 20SRow11_7: 25SRow11_7: TOTALRow11: DATERow12_3: NAME AND ADDRESSRow12_3: 20SRow12_7: 25SRow12_7: TOTALRow12: DATERow13_3: NAME AND ADDRESSRow13_3: 20SRow13_7: 25SRow13_7: TOTALRow13: DATERow14_3: NAME AND ADDRESSRow14_3: 20SRow14_7: 25SRow14_7: TOTALRow14: TOTAL_2: 20STOTAL_7: 25STOTAL_7: TOTALTOTAL: DATERow1_4: NAME AND ADDRESSRow1_4: 20SRow1_8: 25SRow1_8: DATERow2_4: NAME AND ADDRESSRow2_4: 20SRow2_8: 25SRow2_8: DATERow3_4: NAME AND ADDRESSRow3_4: 20SRow3_8: 25SRow3_8: DATERow4_4: NAME AND ADDRESSRow4_4: 20SRow4_8: 25SRow4_8: DATERow5_4: NAME AND ADDRESSRow5_4: 20SRow5_8: 25SRow5_8: DATERow6_4: NAME AND ADDRESSRow6_4: 20SRow6_8: 25SRow6_8: DATERow7_4: NAME AND ADDRESSRow7_4: 20SRow7_8: 25SRow7_8: DATERow8_4: NAME AND ADDRESSRow8_4: 20SRow8_8: 25SRow8_8: DATERow9_4: NAME AND ADDRESSRow9_4: 20SRow9_8: 25SRow9_8: DATERow10_4: NAME AND ADDRESSRow10_4: 20SRow10_8: 25SRow10_8: DATERow11_4: NAME AND ADDRESSRow11_4: 20SRow11_8: 25SRow11_8: DATERow12_4: NAME AND ADDRESSRow12_4: 20SRow12_8: 25SRow12_8: DATERow13_4: NAME AND ADDRESSRow13_4: 20SRow13_8: 25SRow13_8: DATERow14_4: NAME AND ADDRESSRow14_4: 20SRow14_8: 25SRow14_8: 20STOTAL_8: 25STOTAL_8: BUSINESS NAME ADDRESS: CONTACT PERSON: TELEPHONE NUMBER: BRAND NAMERow1: 20SRow1_9: 25SRow1_9: OUNCES OF RYORow1: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow1: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow1: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow1: BRAND NAMERow2: 20SRow2_9: 25SRow2_9: OUNCES OF RYORow2: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow2: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow2: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow2: BRAND NAMERow3: 20SRow3_9: 25SRow3_9: OUNCES OF RYORow3: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow3: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow3: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow3: BRAND NAMERow4: 20SRow4_9: 25SRow4_9: OUNCES OF RYORow4: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow4: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow4: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow4: BRAND NAMERow5: 20SRow5_9: 25SRow5_9: OUNCES OF RYORow5: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow5: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow5: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow5: BRAND NAMERow6: 20SRow6_9: 25SRow6_9: OUNCES OF RYORow6: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow6: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow6: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow6: BRAND NAMERow7: 20SRow7_9: 25SRow7_9: OUNCES OF RYORow7: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow7: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow7: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow7: BRAND NAMERow8: 20SRow8_9: 25SRow8_9: OUNCES OF RYORow8: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow8: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow8: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow8: BRAND NAMERow9: 20SRow9_9: 25SRow9_9: OUNCES OF RYORow9: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow9: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow9: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow9: BRAND NAMERow10: 20SRow10_9: 25SRow10_9: OUNCES OF RYORow10: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow10: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow10: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow10: BRAND NAMERow11: 20SRow11_9: 25SRow11_9: OUNCES OF RYORow11: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow11: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow11: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow11: BRAND NAMERow12: 20SRow12_9: 25SRow12_9: OUNCES OF RYORow12: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow12: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow12: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow12: BRAND NAMERow13: 20SRow13_9: 25SRow13_9: OUNCES OF RYORow13: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow13: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow13: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow13: BRAND NAMERow14: 20SRow14_9: 25SRow14_9: OUNCES OF RYORow14: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow14: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow14: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow14: BRAND NAMERow15: 20SRow15: 25SRow15: OUNCES OF RYORow15: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow15: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow15: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow15: BRAND NAMERow16: 20SRow16: 25SRow16: OUNCES OF RYORow16: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow16: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow16: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow16: BRAND NAMERow17: 20SRow17: 25SRow17: OUNCES OF RYORow17: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow17: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow17: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow17: BRAND NAMERow18: 20SRow18: 25SRow18: OUNCES OF RYORow18: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow18: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow18: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow18: BRAND NAMERow19: 20SRow19: 25SRow19: OUNCES OF RYORow19: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow19: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow19: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow19: BRAND NAMERow20: 20SRow20: 25SRow20: OUNCES OF RYORow20: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow20: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow20: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow20: BRAND NAMERow21: 20SRow21: 25SRow21: OUNCES OF RYORow21: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow21: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow21: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow21: BRAND NAMERow22: 20SRow22: 25SRow22: OUNCES OF RYORow22: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow22: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow22: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow22: BRAND NAMERow23: 20SRow23: 25SRow23: OUNCES OF RYORow23: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow23: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow23: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow23: BRAND NAMERow24: 20SRow24: 25SRow24: OUNCES OF RYORow24: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow24: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow24: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow24: BRAND NAMERow25: 20SRow25: 25SRow25: OUNCES OF RYORow25: NONPARTICIPATING MANUFACTURER NAME ADDRESSRow25: NAME ADDRESS OF THE PERSONS FROM WHOM EACH BRAND WAS PURCHASEDRow25: NAME ADDRESS OF THE FIRST IMPORTER OF FOREIGN MANUFACTURED BRANDSRow25: DATE_2: Text1: Group6: OffbtnReset: btnPrint: NAME: Text4: Text5: Text2: Text3: