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SD EForm - 0885
V1
South Dakota Department of Revenue
Distilled Spirits and Wine Tax Report
Mail to: Special Tax Division, Department of Revenue, 445 E. Capitol Avenue, Pierre, SD 57501-3100
Name: ______________________________________________________
License No.: _____________________________________________________
Address: ____________________________________________________
Month of: _______________________________________________________
City & State: _________________________________________________
Phone No.: ______________________________________________________
(Zip Code)
(a)
(b)
(c)
(d)
(e)
PART A
Wine and Diluted Bev.
Wine
For columns (a through e)
Except Spkg.
Cider
Except Spkg.
Spkg. Wines
Distilled Spirits and
LIST TOTAL WINE GALS.
3.2% - 14%
14.1% - 20%
20.1% - 24%
other Diluted Bev.
$.93
$.28
$1.45
$2.07
$3.93
1.
INVENTORY (beginning of month)
2.
INVENTORY (end of month)
3.
SALES DURING MONTH (Gallons)
4.
RECEIPTS AND IMPORTS
5.
DEDUCTIONS
a. Returned to Mfg.
b. Breakage (carrier, warehouse, delivery)
c. New Placements
d. Stockholders Off. withdrawals
e. Tax Paid Purchases
6.
TOTAL DEDUCTIONS (Add 5a,b,c,d,e)
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
7.
NET TAXABLE (line 4 minus line 6)
PART B – Tax Computation:
0.00
a.
Wine – 3.2% - 14%…………………………(Column a, line 7)…………………………Gals. x $.93 =
$
0.00
b.
Cider………………………………………...(Column b, line 7)…………………………Gals. x $.28 =
$
0.00
c.
Wine – 14% - 20%………………………….(Column c, line 7)………………………….Gals. x $1.45 =
$
0.00
d.
Wine – 20% - 24%; All Spkg. Bev. ………..(Column d, line 7)………………………….Gals. x $2.07 =
$
0.00
e.
All Other Wines and Spirits………………...(Column e, line 7)………………………….Gals. x $3.93 =
$
$0.00
0.00
f.
Total purchase price of alcoholic beverages, Part C $ _________________________________ x 2% =
$
0.00
g.
Total Tax Due (total line a through line f) …………………………………………………………..
$
h.
Penalty ………………………………………………………………………………………………
$
0.00
i.
Total Tax and Penalty Due ………………………………………………………………………….
$
Report MUST be filed with full payment on or before the 25th of the second month following report period.
I declare under the penalty of perjury that this report has been examined by me and to the best of my knowledge and belief is a true, correct and
complete report.
Signature of Licensee
Date
Signature of Preparer
(FOR OFFICE USE)
A.B. Purchase Price Fund No. 4003 $
Liquor Tax No. 0087 $
SD Rev. SPT – 103 - 98