Form 04-503 - Alcoholic Beverage Excise Tax Return Page 3
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5State of Alaska
Alcoholic Beverage Excise Tax
Supporting Schedule of Gallons Sold or Consigned
AS 43.60.020
Business Name
Month and Year
Page
of
This is a supporting schedule for Alcoholic Beverage Tax Return Form 04-500. Use a separate schedule for each of the categories
that applies to your business for the month for which you are making the return. Use additional pages as necessary.
Gallons sold or consigned to retail establishments or individuals
Check one category:
Gallons sold to military establishments
Gallons sold or consigned to a licensed warehouse
Number of Gallons
Name and Alaska Address of
Judicial
Beer & Malt
Buyer(s) or Consignee(s)
District
Beer, Malt
Beverages Qualifying
Liquor
Wine
Beverages & Cider
for Reduced Tax Rate
Totals carried forward
Total (carryforward to page 1)
0.000
0.000
0.000
0.000
Form 04-501 Webform (Rev 04/04)
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