Alaska Alcoholic Beverage Excise Tax Return Form
In Alaska, alcohol beverage enterprises must file this form and pay for the corresponding tax amount by the last day of the month following the month of the sale/consignment of their products.Download
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0405-500 Rev 09/12 - page 1 EINFor the Month of Year SSN Individual or Corporation Name DOR License Number Check if amended return Check if zero return Business Name Telephone NumberFax Number Mailing Address Contact PersonTitle City StateZip Code Email Address Schedule A Tax Calculation : Enter the information requested below from Schedule B. 1. GALLONS OF LIQUOR District 1District 2District 3District 4 Total a Taxable Gallons b Tax Rate 12.80 c Total Tax (multiply taxable gallons by tax rate) 2. GALLONS OF WINE Total a Taxable Gallons b Tax Rate 2.50 c Total Tax (multiply taxable gallons by tax rate) 3. GALLONS OF BEER, MALT BEVERAGES & CIDER Total a Taxable Gallons b Tax Rate 1.07 c Total Tax (multiply taxable gallons by tax rate) 4. GALLONS OF BEER & MALT BEVERAGES QUALIFYING FOR REDUCED RATE OF TAX (see instructions) Total a Taxable Gallons b Tax Rate 0.35 c Total Tax (multiply taxable gallons by tax rate) 5. IF AMENDED, PREVIOUS AMOUNT PAID 6. TOTAL ALCOHOLIC BEVERAGE TAX DUE (add lines 1c through 4c less line 5) I declare under penalty of perjury that the information provided in this\ return, including accompanying schedules and statements, has been reviewed by me and to the best of my knowledge and belief is true, \ correct, and complete. Signature Printed NameDate File and Pay online at www.tax.alaska.gov Due Date: This return must be filed and the tax paid on or before the last day of each calendar month following the month the alcohol was sold or consigned into Alaska or removed from a licensed bonded warehouse in Alaska. Submit one return for each licensed facility. Required Attachments. Attach the original copies of all applicable schedules (B,C,D,E and F)\ and the inventory report (Schedule G) Payment Information Department Use Only PMD Validation DEPARTMENT USE ONLY ENV FSN Mail to: Alaska Department of Revenue, PO Box 110420, Juneau AK 99811-0420 Note: If your liability is $100,000 or more, you must pay using the Onli\ ne Tax Information System (OTIS) at www.tax.alaska.gov or by wire transfer. Check if you are remitting by: OTIS confirmation # Wire transfer date 500 500 Alaska Alcoholic Beverage Excise Tax Return Alaska Alcoholic Beverage Excise Tax Return 0405-500 Rev 09/12 - page 2 Schedule B: Gallons Sold in Alaska Business NameMonth and Year Page ______of ______ Licensed Location DOR License Number This is a supporting schedule of taxable gallons sold in Alaska to retail establishments and individuals and must accompany Schedule A. Each district total and alcohol type total should be reported on Line (a) of sections 1 - 4 of Schedule A and line 4 of Schedule G, the Inventory Report. Use additional sheets as necessar\ y. Number of Gallons Name AND Alaska address of taxable sales to retailers or individuals (A single line should be used to report the total of all individual consumer sales) Judicial District (destination of the sale) Liquor WineBeer, Malt Beverages & Cider Qualified Reduced Tax Rate Beer & Malt Beverages Totals: 500 500 Alaska Alcoholic Beverage Excise Tax Return Alaska Alcoholic Beverage Excise Tax Return Alaska Alcoholic Beverage Excise Tax Return 0405-500 Rev 09/12 - page 3 Schedule C: Gallons Sold to Military Establishments Business NameMonth and Year Page ______of ______ Licensed Location DOR License Number This is a supporting schedule of tax exempt gallons sold in Alaska to military establishments that meet all requirements for tax exempt status as defined in U.S.C. 4-107. The total must be reported on line 5 of Schedule G, the Inventory Report. Use additional sheets as necessary. Number of Gallons Name AND Alaska address of tax exempt sales to Qualified Military Establishments. Judicial District (destination of the sale) Liquor WineBeer, Malt Beverages & Cider Qualified Reduced Tax Rate Beer & Malt Beverages Totals: 500 500 Alaska Alcoholic Beverage Excise Tax Return Alaska Alcoholic Beverage Excise Tax Return 0405-500 Rev 09/12 - page 4 Schedule D: Consigned or Sold to a Licensed Bonded Warehouse in Alaska Business NameMonth and Year Page ______of ______ Licensed Location DOR License Number This is a supporting schedule of tax exempt gallons consigned or sold to a licensed bonded warehouse in Alaska. The total must be reported on line 6 of Schedule G, the Inventory Report. Use addi\ tional sheets as necessary. Number of Gallons Name AND Alaska address of tax exempt sales or consignments to a Licensed Bonded Warehouse in Alaska Judicial District (destination of sale) Liquor WineBeer, Malt Beverages & Cider Qualified Reduced Tax Rate Beer & Malt Beverages Totals: 500 500 Alaska Alcoholic Beverage Excise Tax Return Alaska Alcoholic Beverage Excise Tax Return Alaska Alcoholic Beverage Excise Tax Return 0405-500 Rev 09/12 - page 5 Schedule E: Gallons Sold Out of State Business Name Month and Year Page ______of ______ Licensed Location DOR License Number This is a supporting schedule of tax exempt gallons shipped for sale or consignment out of state. The total must be reported on line 7 of Schedule G, the Inventory Report. Use additional sheets as necessary . Number of Gallons Name AND address of tax exempt sales or consignments out of state. Liquor WineBeer, Malt Beverages & Cider Qualified Reduced Tax Rate Beer & Malt Beverages Totals: 500 500 Alaska Alcoholic Beverage Excise Tax Return Alaska Alcoholic Beverage Excise Tax Return 0405-500 Rev 09/12 - page 6 Schedule F: Distributor’s (Licensed Bonded Warehouses Only) Schedule of Sales of Reduced Tax Rate Beer and Malt Beverages Business NameMonth and Year Page ______of ______ Licensed Location DOR License Number This is a supporting schedule for the Alcoholic Beverage Tax Return. Distributors (Licensed Bonded Warehouses only) must complete this schedule if they sold beer or malt beverages from a brewery approved by DOR for the reduced rate of tax provided by AS 43.60.010(c). The amount of qualified reduced tax rate beer and malt beverages sold must agree with the totals of qualified reduced tax rate beer and malt beverages reported on Schedules B, C, D and E. Use additional sheets as necessary. Name AND Address of Qualifying DOR approved Reduced Rate Brewers. Gallons of Qualified Reduced Tax Rate Beer & Malt Beverages Sold Totals: 500 500 Alaska Alcoholic Beverage Excise Tax Return Alaska Alcoholic Beverage Excise Tax Return Alaska Alcoholic Beverage Excise Tax Return 0405-500 Rev 09/12 - page 7 Schedule G: Inventory Report Business Name For the Month ofYear Inventory Location DOR License NumberTelephone Number All Alcoholic Beverage Licensees must complete this form for each licensed l\ ocation. This form must accompany Schedule A regardless of sales activity for the month. List inventory quantities b\ elow. Quantity means the total liquid content expressed in U.S. gallons, not the number of pallets, cases, bottles or cans which contain alcoholic beverages. Metric units must be converted to U.S. gallons. For purposes of converting totals, 3.785 liters equals one U.S. gallon. Number of Gallons Liquor WineBeer, Malt Beverage & Cider Qualified Reduced Tax Rate Beer & Malt Beverages 1 Beginning inventory. Gallons on hand at the beginning of month (Should equal the ending inventory from the previous month) * 2 Gallons received or produced during the month 3 Total gallons. Add (Lines 1 and 2) 4 Gallons sold in Alaska (from Schedule B) 5 Gallons sold to military establishments (from Schedule C) 6 Gallons transferred to a licensed warehouse in Alaska (from Schedule D) 7 Gallons sold out of state (from Schedule E) 8 Subtotal (subtract Lines 4 through 7 from Line 3) 9Increase or (decrease) due to gain or (loss) - explain fully below 10 Ending inventory (sum of Line 8 and Line 9) Instructions Line 1 - Beginning inventory should match the reported ending inventory \ from the previous month (* if not, provide explanation) Line 2 - Report all gallons purchased, manufactured, transferred from ot\ her warehouse locations or returned to this storage location Line 4 - Report all gallons sold to retailers and individuals in the sta\ te Line 5 - Report all gallons sold to military establishments Line 6 - Report all gallons transferred or sold to a licensed warehouse \ in Alaska Line 7 - Report all gallons transferred for sale out of state Line 8 - Subtract Lines 4 through 7 from Line 3 Line 9 - Enter decrease as a negative number. Must be fully explained in the “Explanation” box Line 10 - Ending inventory must equal the beginning inventory for the ne\ xt month Explanation: List each type of (loss) or gain from line 9 (see instructions). 500 500 Alaska Alcoholic Beverage Excise Tax Return Alaska Alcoholic Beverage Excise Tax Return
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