West Virginia License Information - Report of Ethyl Alcohol Received and Used
- Who must complete this form: Anyone who has a West Virginia Ethyl Alcohol License and received or used Industrial Ethyl Alcohol.
- Renewal Frequency: On or before the 10th day of the succeeding month by the holder of the license.
- Approximate Time to Complete All Forms: 5-10 minutes
Blank Form Downloads
Follow these steps to complete the West Virginia Ethyl Alcohol Order Form:
NOTE: ABC Form 139, must be prepared and transmitted by email to the West Virginia Alcohol Beverage Control Commissioner on or before the 10th day of the succeeding month by the holder of the license to purchase and use ethyl alcohol.
Where there is no alcohol received, used or on hand, ABC Form 139 should be rendered in blank, with the notation “No transactions” written across the face of the form.
Step 1: Open ABC Form 139
Step 2: Enter in your Ethyl Alcohol License Number in the top right corner of the application.
Step 3: Enter in your Licensee name (Name listed on the license), the address, and the month you are reporting.
Step 4: Fill out the table detailing the alcohol you received during the month.
Step 4a: In Column 1 Date the shipment of alcohol reaches the licensee.
Step 4b: In Column 2 enter the vendor name.
Step 4c: In Column 3 enter the vendor address.
Step 4d: In Column 4 enter the serial numbers on the packages received.
Step 4e: In Column 5 & 6 enter the number of wine gallons in the shipment and proof of the alcohol. Then enter the total number of gallons received for that month.
Step 5: Fill in the months summary
Step 5a: Line 1 should be reported the amount shown on hand the last day of the month on the report made for the previous month.
Step 5b: Line 2 enter the total of alcohol received during the month as shown by Column 5.
Step 5c: Line 4 report the quantity used during the month.
Step 5d: At Line 5 should be reported any shortage from packages when received or any loss of alcohol after receipt. Any discrepancy between the amount of alcohol actually on hand at the end of the month and the amount which should be on hand must be reported at this line. All entries at this line must be fully explained by separate affidavits attached to and accompanying the report.
Step 5e: Line 6 report the amount of alcohol actually on hand on the last day of the month.
Step 6: Do not fill out any information in this last section until you are before a Notary Public. You will sign the document before the Notary and they will fill out the last bit of information required.
Step 7: E-mail the document to: firstname.lastname@example.org. Make sure this form is submitted on or before the 10th day of the succeeding month by the holder of the license. Failure to submit the form on time each month could result in a revoked license.