FYI - check appropriate 'quarter covered by box' and Tab to continue.
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Make your check payable and mail to:
COMMON CARRIER ALCOHOL BEVERAGE TAX RETURN
Wisconsin Department of Revenue
PO Box 8900
Use this form to report the consumption of liquor, wine, apple cider and fermented malt
Madison, WI 53708-8900
beverages on dining cars and airlines while in transit through or over the State of Wisconsin.
Phone: (608) 266-6702
Due Date: 15 days after the end of the quarter covered by this return.
ndicate quarter covered by this return
I
Year
Jan- Mar
July - Sept
(check box and fill in the year)
Apr- June
Oct - Dec
Name
Federal Employer ID No. (FEIN)
Mailing Address - Street or P. O. Box Number
City
State
Zip Code
COMPLETE WORKSHEET ON REVERSE SIDE BEFORE COMPUTING THE TAX DUE BELOW
RECORD OF CONSUMPTION AND TAX COMPUTATION
Container
Taxable Sales
Line
Amount Due
Tax Type
Type & Size
from Worksheet
Tax Rate
Tax Due
Number Sold
Liquor
1
X $.04293
Miniatures
Liters Sold
Liquor
LIQUOR
2
X $.8586
(all other sizes)
(distilled spirits)
Add lines 1 and 2
LIQUOR TAX
3
Liters Sold
Wine
4
X $.06605
14% or less
Liters Sold
Wine - Over 14% but
WINE
5
X $.1189
less then 21%
6
Add lines 4 and 5
WINE TAX
Liters Sold
APPLE
APPLE
Apple Cider
7
X $.0171
CIDER TAX
CIDER
7% or less
Number Sold
X $.006048
BEER TAX
BEER
8
12 oz. Bottles or Cans
TAX DUE (attach check with your return or pay by EFT)
9
Check this box if you are paying the tax due on line 9 by electronic funds transfer (EFT)
*Call (608) 264-9918 for information about paying taxes by EFT.
Under penalty of law, I declare the above information to be true, correct and complete to the best of my knowledge and belief.
Title
Date
Business Telephone Number
Signature
(
)
INSTRUCTIONS:
1.
Your return is due 15 days after the end of the quarter covered by the return (for example: a return covering the quarter January
through March is due April 15). Please retain a copy of this return in your records.
2.
To be timely filed, a return must be postmarked by its due date and received by the department within 5 days of the due date. Late-
filed returns are subject to a statutory $10 late-filing fee plus interest at the rate of 1.5% per month calculated from the due date until
the date the tax is paid.
AB-154 (R. 7-04)