Form B-C-775 - Spirituous Liquor Tax Return - 2009

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B-C-775
Spirituous Liquor Tax Return
Web
North Carolina Department of Revenue
9-09
Return for Month Ended
(MM-DD-YY)
DOR Use Only
Name of County or Municipal ABC Board (First 35 Characters) (USE CAPITAL LETTERS FOR YOUR NAME AND ADDRESS)
Street Address
FEIN or SSN
City
State
Zip Code
Name of Contact Person
Phone Number
State of Domicile
NCDOR ID/Account Number
Fill in circle if applicable:
Payment has been made through electronic funds transfer (EFT)
Amended Return
Computation of Tax on Spirituous Liquor Sales and Mixed Beverages Surcharge
,
,
.
00
1.
Total Retail Sales of Spirituous Liquor
1.
,
,
.
00
2.
a. 1¢ or 5¢ bottle charge
2a.
,
,
.
b. Additional 1¢ or 5¢ bottle charge
2b.
00
,
,
.
c. $20 on each four liters of spirituous liquor sold to a mixed
beverage permittee for resale in mixed beverages and to a
00
2c.
guest room cabinet permittee for resale
,
,
.
00
d. Bailment Surcharge
2d.
,
,
.
3.
Net Sales of Spirituous Liquor Including the 30% State Excise
Tax and the 3 1/2% add-on for Local Boards
(Line 1 minus Lines
00
3.
2a through 2d)
,
,
.
4.
Taxable Sales of Spirituous Liquor Excluding the 30% State
Excise Tax and the 3 1/2% add-on for Local Boards
00
4.
Line 3 divided by 133.5%
,
,
.
5.
State Excise Tax Due
5.
00
Multiply Line 4 by 30%
,
,
.
6.
State’s Share of Mixed Beverages Surcharge
00
6.
Multiply Line 2c by 50%
,
,
.
7.
Tax Due
00
7.
Add Lines 5 and 6
,
,
.
8.
Penalty
(10% for late payment; 5% per month, maximum 25%, for late filing)
00
8.
Multiply Line 7 by rate above if return with full payment is not filed timely.
,
,
.
9.
Interest
(See the Department’s website, , for current interest rate.)
9.
00
Multiply Line 7 by applicable rate if return with full payment is not filed timely.
,
,
.
$
10. Total Due
00
10.
Add Lines 7 through 9
Signature:
Title:
Date:
I certify that, to the best of my knowledge, this return is accurate and complete.
Returns are due on or before the 15th day of the month following the month in which the tax was collected. Your check or money order
must be in the form of U.S. currency from a domestic bank.
North Carolina Department of Revenue, Alcoholic Beverage and Amusement Tax Unit, PO Box 25000, Raleigh, NC 27640-0110

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