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Print Form Commonwealth of Massachusetts Alcoholic Beverages Control Commission 239 Causeway Street Boston MA 02114 www. mass. gov/abcc The SCHEDULE OF PRICES TO WHOLESALERS This schedule must be typewritten or printed Effective for the month of Commission has or may hereafter adopt. Print Form Commonwealth of Massachusetts Alcoholic Beverages Control Commission 239 Causeway Street Boston MA 02114 www. mass. gov/abcc The SCHEDULE OF PRICES TO WHOLESALERS This schedule must be typewritten or printed Effective for the month of Commission has or may hereafter adopt. The undersigned licensee or his duly authorized representative files the following schedule of prices pursuant to the requirements of Sections 25A and 25B Chapter 138 of the General Laws as amended* This schedule is signed under the penalties of perjury. Date Address of licensed premises Name of Licensee City/Town Signature Massachusetts License or Certificate Number Type of Beverage and brand name Capacity of Container State Where stated on label Age If a blend and kind of Neutral Spirits Proof or Alcoholic Content Price Per bottle if so sold Per Case Zip Code of Discount Bottles for Quanity Per Case. mass. gov/abcc The SCHEDULE OF PRICES TO WHOLESALERS This schedule must be typewritten or printed Effective for the month of Commission has or may hereafter adopt. The undersigned licensee or his duly authorized representative files the following schedule of prices pursuant to the requirements of Sections 25A and 25B Chapter 138 of the General Laws as amended* This schedule is signed under the penalties of perjury. The undersigned licensee or his duly authorized representative files the following schedule of prices pursuant to the requirements of Sections 25A and 25B Chapter 138 of the General Laws as amended* This schedule is signed under the penalties of perjury. Date Address of licensed premises Name of Licensee City/Town Signature Massachusetts License or Certificate Number Type of Beverage and brand name Capacity of Container State Where stated on label Age If a blend and kind of Neutral Spirits Proof or Alcoholic Content Price Per bottle if so sold Per Case Zip Code of Discount Bottles for Quanity Per Case. mass. gov/abcc The SCHEDULE OF PRICES TO WHOLESALERS This schedule must be typewritten or printed Effective for the month of Commission has or may hereafter adopt. The undersigned licensee or his duly authorized representative files the following schedule of prices pursuant to the requirements of Sections 25A and 25B Chapter 138 of the General Laws as amended* This schedule is signed under the penalties of perjury. Date Address of licensed premises Name of Licensee City/Town Signature Massachusetts License or Certificate Number Type of Beverage and brand name Capacity of Container State Where stated on label Age If a blend and kind of Neutral Spirits Proof or Alcoholic Content Price Per bottle if so sold Per Case Zip Code of Discount Bottles for Quanity Per Case. .

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