Form 04-503 - Alcoholic Beverage Excise Tax Return Page 5
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5State of Alaska
his form is available online at
SEND TO:
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Alcoholic Beverage Excise Tax
State of Alaska
Department Of Revenue, Tax Division
Inventory Report
PO Box 110420
Juneau, AK 99811-0420
15 AAC 60.010 (b)
Telephone 907.269.1041; Fax 907.269.6644
Use this monthly report to list the quantity of alcoholic beverage received in, sent out from, and remaining on the premises of the location named below. Attach
the report to your Alcoholic Beverage Tax Return (Form 04-500).
Note: A separate Inventory Report must be filed for each location where alcoholic beverages are stored.
Business Name
For the Month of
Year
Inventory Location
License Number
Telephone Number
List inventoryquantities below. "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 equal one U.S. gallon.
Beer & Malt
Beer, Malt
Beverages
Liquor
Wine
Beverages & Cider
Qualifying for
Reduced Tax Rate
1. Beginning Inventory. Gallons on hand at beginning of
month (Should equal the ending inventory from the
previous month). . . . . . . . . . . . . . . . . . . .
2. Received at the warehouse or brewed during the month
. . . . . . . . . . . . . . . . . . . . . . . .
0.000
0.000
0.000
0.000
3. Total. Add lines 1 and 2 . . . . . . . . . . . . . . . . . . . . . . . . .
4. Gallons sold or consigned in Alaska. . . . . . . . . . . . . . . . . (
) (
) (
) (
)
5. Credit for losses or returns (explain in remarks). . . . . . . . (
) (
) (
) (
)
0.000
0.000
0.000
0.000
6. Ending Inventory. Subtract lines 4 and 5 from line 3.
Remarks:
Instructions:
Line 1 - Ending Inventory from the previous month
Line 2 - Report all gallons purchased, brewed, transferred from other warehouse locations or returned to this storage location
Line 4 - Report all gallons sold or consigned to retailers, the military or other licensed warehouses from this storage locatio
Line 5 - Report all gallons lost due to errors in inventory, breakage, or damage. Also report gallons returned to manufacturers or other seller
Line 6 - Beginning Inventory for the next month
I declare under penalty of unsworn falsification that this report is supported by true, correct and complete records which are available for inspection, that the report has been
examined by me, and to the best of my knowledge and belief is true, correct and complete.
Signature of Taxpayer
Title
Date
Form 04-503 Webform (Rev 04/04)
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