Form Ltd 1 - Liquor Excise Tax Return - Nevada Department Of Taxation
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4NEVADA DEPARTMENT OF TAXATION
1550 E. College Parkway, Carson City, Nevada 89706
LIQUOR EXCISE TAX RETURN
DUE ON OR BEFORE THE 20
OF THE FOLLOWING MONTH
TH
Payable for the month of ........................................ , 20 .........
Firm Name........................................................................., .....................................................................................................
(Address)
Account No..............................................
.............................................................................................................................
(City)
(Zip)
This Return MUST Be filed Each Month Whether or Not Liquor Is Imported/Manufactured
MALT BEVERAGE
ALCOHOLIC BEVERAGES
OFFICE USE ONLY
TRANSACTIONS DURING
Keg or
Bottled or
Total Malt
.5% to 14%
14.1% to 22%
22.1% to 80%
THE MONTH IN GALLONS
Draught
Canned
Beverage
1. Total Imports into Nevada
Postmark:
2. Credit: Breakage, Loss -0.5%
3. Credit Exports/Sales -0.5%
Ck. No:
4a. Credit Military Sales -0.5%
_________
_________
_________
_________
_________
__________
Date:
4b. Credit Airline Sales -0.5%
$
5. TOTAL DEDUCTIONS
Initials:
6. TOTAL TAXABLE GALLONS
$ .16 per gal.
$ .70 per gal.
$ 1.30 per gal.
$ 3.60 per gal.
7. Tax Rates for liquor categories
$
8. Gross Tax (taxable gallons times tax rate)
-
9. Discount of 0.5%, allowed if return is postmarked on or before the 15
of the month following activity
th
$
10. Adjusted tax, amount due and payable with this return
CORRECTIONS AND ADJUSTMENTS FROM PREVIOUS MONTHLY REPORTS
Liquor Categories
Month
Shipper
Invoice No.
Gallons
Over Reported
Under Reported
Extension
Credit
Debit
-0.5%
Malt Beverage
$ .16 per gallon
Wine
$ .70 per gallon
Wine
$1.30 per gallon
Spirits
$ 3.60 per gallon
Other-Explain
Penalty due
10%
Interest due
1% per month
$
Total Due
The foregoing report in all respects is true and correct to the best of my knowledge and belief, together with all attached schedules; that I am
the importer, manufacturer, or officer of the above firm and duly qualified and authorized to verify this report.
Reported By....................................................................................
Signed ..................................................................................................................
Checked by....................................................................................... Title ......................................... Phone No........................................................
Page 1
LTD 1 (10/03)
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