Vessel Excise Tax Monthly Return Form Page 2

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210
Federal ID
SSN
EIN
Vessel call sign
Taxpayer name
Vessel name
Period ending (year/month)
Schedule B – Voyage Information
Begin Date
End Date
Total # of
Line #
Voyage #
Port of Origin
Final Port
(MMDDYYYY)
(MMDDYYYY)
Passengers
1
2
3
4
5
6
7
Total
Schedule C – Ports of Call Detail (Report first 5 ports only)
Alaska Port Codes
Voyage # (Schedule B)
Alaska Port of Call
Alaska Port Code
Number of Passengers
Anchorage
ANC
Port 1
Dutch Harbor/Unalaska
DH
Port 2
Port 3
Haines
HNS
Port 4
Homer
HOM
Port 5
Juneau
JNU
Port 1
Ketchikan
KTN
Port 2
Kodiak
KDK
Port 3
Metlakatla
MET
Port 4
Nome
NOM
Port 5
Petersburg
PTB
Port 1
Point Sophia/Icy Straits/
PTS
Port 2
Hoonah
Port 3
Seward
SEW
Port 4
Sitka
SIT
Port 5
Skagway
SKG
Port 1
St. Matthew
STM
Port 2
Valdez
VDZ
Port 3
Whittier
WHT
Port 4
Wrangell
WRG
Port 5
Yakutat
YAK
Port 1
Port 2
Port 3
Port 4
Port 5
Port 1
Port 2
Port 3
Port 4
Port 5
210
Form 0405-210.2 New 04/07 • page 2
Attach page if more than six voyages.

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