Form Lb123 - Common Carrier Monthly Return
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2LB123
Common Carrier Monthly Return
Common carriers: complete this return if you sold distilled spirits, wines and fermented malt beverages to passengers being
transported within Minnesota according to Minnesota Statutes 297C.
Due on or before the 18th of each month.
Name of company
Minnesota tax ID number
Address
City
State
Zip
Month/year of return
A
B
C
Excise tax
Minnesota liters
Total tax
Distilled spirits and wine
1 Liquor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $1.33
×
=
2 Sparkling wine . . . . . . . . . . . . . . . . . . . . . . . . .
0.48
×
=
3 Wines over 14% . . . . . . . . . . . . . . . . . . . . . . . . .
0.25
×
=
4 Wines 14% or less . . . . . . . . . . . . . . . . . . . . . . .
0.08
×
=
5 Miniatures (bottles) . . . . . . . . . . . . . . . . . . . . . .
0.14
×
=
6 Total tax on liquors and wine (add lines 1C through 5C) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
A
B
C
Rate
Minnesota barrels
Total tax
Fermented malt beverages
7 3.2% alcohol or less . . . . . . . . . . . . . . . . . . . . . $2.40 BBL ×
=
8 More than 3.2% alcohol . . . . . . . . . . . . . . . . . . . $4.60 BBL ×
=
9 Total tax on beer (add lines 7C and 8C) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total tax due
10 Total tax payment (add lines 6C and 9C) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Check method of payment:
Electronic payment
Check
(make payable to Minnesota Revenue)
I declare that this return is correct and complete to the best of my knowledge and belief.
Authorized signature
Date
Daytime phone
(
)
Print name
Title
Paid preparer’s signature
Minnesota tax ID, SSN or PTIN
Date
Daytime phone
(
)
Mail to Minnesota Revenue, Mail Station 3331, St. Paul, MN 55146-3331
Phone 651-297-1882. TTY: 711 Minnesota Relay.
(Rev. 9/04)
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