Form 73a628 - Distributor'S Monthly Malt Beverage Wholesale Sales Tax And Excise Tax Report
Download a blank fillable Form 73a628 - Distributor'S Monthly Malt Beverage Wholesale Sales Tax And Excise Tax Report in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 73a628 - Distributor'S Monthly Malt Beverage Wholesale Sales Tax And Excise Tax Report with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Distributor's Monthly Malt
73A628 (05-13)
FOR DEPARTMENT USE ONLY
Beverage Wholesale Sales
Commonwealth of Kentucky
_ _ _ _ _ _
/ 23
/ _ _ / _ _
Account Number
Tax
Mo.
Yr.
DEPARTMENT OF REVENUE
Tax and Excise Tax Report
File with the Department of Revenue on or before the 20th of the month following the month for which the transaction(s) occurred.
Name and Address of Principal or Agent
Revenue Account Number
State License Number
Report for Month of
For assistance, you may contact the Excise Tax Section at (502) 564-6823 or via email at DOR.WEBResponseExciseTax@ky.gov.
1. Gross receipts from sales of malt beverages (excluding container deposits and tax) ……………………………………………………………
$
2. Gross receipts subject to tax from Microbrewer's Report to Distributor (Attach Form 73A630)………………………………….. ……….
$
3. Total gross receipts subject to tax (Add line 1 and line 2)…………………………………………………………………………………………………………
$
a. Malt beverages returned by Kentucky retailers ………………………………………………………
$
4. LESS:
b. Malt beverages sold to Kentucky distributors ………………………………………………………
$
c. Export sales ………………………………………………………………………………………………………………….
$
d. Malt beverages sold to agencies and instrumentalities of the federal
government ……………………........……..……..…………………………………..……
$
e. Total of lines a, b, c, and d ………….….…………….…………………….………………………………………………………………….………
$
5. Net receipts (line 3 minus line 4e) …………………………………………………………………………………………..…………………………………………
$
6. Gross tax applicable (line 5 times .11) ………………….…..……………………….………………………………………...……………………………………
$
7. Collection and reporting fee (line 6 times .01) ……………………………………….………………………………………………………….. .….………
$
8. Net tax due (line 6 minus line 7) ………………………………………………..………………………..……………………….…………….
$
9. Miscellaneous credits and charges ………………...……………………………………………….….……………………………………………………….
$
23
10. Total wholesale sales tax due (line 8 plus or minus line 9) …………………………………………………………………………………………………. ……
$
23
11. Total excise tax due ( enter from line 7 on reverse)………...………………….………………………………….. ……….
18
$
12. Total amount included (line 10 plus line 11) ……….………….…....…………………………………………….……………………..
$
IMPORTANT NOTICE:
Make check(s) payable to Kentucky State Treasurer.
Mail report and check(s) to Kentucky Department of Revenue, Frankfort, Kentucky 40619
I, the undersigned, a principal officer of the above-named licensee, certify that I have examined this report and it is, to the
best of my knowledge and belief, a true, correct and complete report.
Print Name
Signature
Title
Date
Phone Number
E-Mail
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial