Form Liq-Stc - Supplier Liquor Excise Tax Return Form Sales To Consumers
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1
2NEVADA DEPARTMENT OF TAXATION
TID # ________________________
SUPPLIER LIQUOR EXCISE TAX RETURN
SALES TO CONSUMERS
Mail original to: Nevada Department of Taxation
FOR DEPARTMENT USE ONLY
1550 COLLEGE PARKWAY SUITE 115
CARSON CITY, NV 89706
DATE:
CHECK NO:
(775) 684-2125
CHECK AMOUNT:
AMOUNT PAID:
POSTMARK:
INITIALS:
FOR MONTH ENDING:
DUE ON OR BEFORE:
If postmarked after due date, penalty and interest will apply.
If the name or address as shown is incorrect, if the ownership or the
business location has changed, or if you are out of business, notify the
Liquor Excise Tax Examiner at the Carson City District Office.
A RETURN MUST BE FILED WHETHER OR NOT THERE IS ACTIVITY
See Instructions and Wine Gallon Conversion on the reverse side
COPIES OF INVOICES WITH NAME AND ADDRESS OF RECIPIENT MUST ACCOMPANY THIS RETURN
LIQUOR TYPE
WINE GALLONS
TAX RATE
TAX AMOUNT DUE
1. BEER
$ .16
2. WINE .5% TO 14%
$ .70
3. WINE 14.1% TO 22%
$ 1.30
4. LIQUOR 22.1% TO 80%
$ 3.60
. TOTALS:
5
$
6
If paid on or before the 15th of the month, take a 0.25% Discount
.
-
7. Adjusted Tax, the amount due and payable with this return
$
8. Less credits approved by the Department
.
-
$
9
Penalty, if paid after due date (see instructions for rate).
.
th
10.
0.75%
interest, per month, due if postmarked after the 20
of the
$
month.
$
11. Add liabilities established by the Department.
12.
TOTAL AMOUNT DUE:
$
I hereby certify that this return, including all attachments, has been examined by me and to the best of my knowledge and
belief is a true, correct and complete return; that I am the Supplier, or Officer of the Supplier and duly qualified and
authorized to verify this return.
Prepared by _____________________________
Signed ________________________________________________
Checked by ______________________________
Title__________________ Phone No (
) __________________
MAKE CHECK PAYABLE TO THE NEVADA DEPARTMENT OF TAXATION
LIQ-STC (05/15)
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