Form 725 - Indiana Farm Winery Excise Tax Report - 2009

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Indiana Department of Revenue
For Departmental Use Only
A. _______________
Indiana Farm Winery Excise Tax Report
B. _______________
C. _______________
Form 725
Reporting Month _________________Year _____________
State Form 46692
(The report is due on or before the 20th day of the month following the month being reported.)
(R3 / 3-09)
Name (Indiana Farm Winery)
Federal Identification Number
Mailing Address
Tax Identification Number
City
State
Zip Code
State Farm Winery Permit Number
Federal Permit Number
Direct Wine Permit Number (if applicable)
GALLONS
Production and Purchases:
1.
Gallons per federal Schedule 5120.17 (Wine Taken Out of
1A. Bulk _______________
Bond) Attach copy of federal schedule.
1B. Bottled _____________
2.
Total Gallons: Line 1A + Line 1B.
2. _________________
3.
Gallons Sold as Direct Wine Sales to customers in Indiana
3. ________________
Deduct:
4.
Gallons Returned to Winery (from Schedule FW 725 - Box A)
4. _________________
5.
Gallons Sold Tax Exempt (from Schedule FW 725 - Box B)
5. _________________
6.
Total Deductions: Add Lines 4 and 5.
6. _________________
7.
Gallons Subject to Tax: Line 2 minus Line 6.
7. _______________
TAX
8.
Multiply Taxable Gallons by Tax Rate: Line 7 x $0.47
8. _________________
9.
Timely Payment Discount: Line 8 x 1.5 percent (.015)
9. _________________
10.
Tax Due: Line 8 minus Line 9.
10. _________________
11.
Adjustments Authorized by Department of Revenue (Attach Supporting Documentation)
11. _________________
12.
Penalty: If return filed after the due date, add penalty of 10 percent of Line 8 or $5.00
whichever is greater. (Penalty is $5.00 if return is filed late with no tax due.)
12. _________________
13.
Interest: If return is filed late, add interest. (Call Department of Revenue (317) 615-2710)
13. _________________
14.
Total Amount Due: Line 10 + or - Line 11 + Line 12 + Line 13.
14. _________________
Discount (Line 9) does not apply unless the report and payment is timely filed.
I declare, under penalty of perjury, that this is a true, correct and complete form.
_______________________________________________________________________________________________
Name of Agent or Officer
Signature of Agent or Officer
_______________________________________________________________________________________________
Date
Telephone Number
Mail to:
Indiana Department of Revenue
(check if)
P.O. Box 6114
Final Return
Indianapolis, Indiana 46206-6114
Close Date ______________________
Questions related to this form: Call (317) 615-2710

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