Reset Form
ALC 83
Rev. 8/11
P.O. Box 530
Columbus, OH
43216-0530
Ohio Beer and Malt Beverage Tax Return
Return is due on or before the 10th day of
Reporting Period
the month following the reporting period.
For Department of Taxation
For the month/quarter of
20
Use Only
Account number
Name
Address
City
State
ZIP
$
1. Schedule A line 3
2. Schedules B and B1 line 4
$
3. Total beer and malt beverage tax liability (total of lines 1 and 2)
$
4. Monthly advance tax payment received by Department of Taxation
on or before 18th day of report period
$
5. If line 3 exceeds line 4, enter difference here
$
6. If line 3 exceeds line 4, enter 10% of line 4
$
7. Discount (enter 3% of line 5 or 6, whichever is smaller)
$
Complete lines 4
8. If line 4 exceeds line 3, enter difference here
$
through 12 only if you
made an advance pay-
9. Monthly advance tax payment received by Department of Taxation
$
ment.
between the 19th and the last day of the report period
10. Credit balance, if any, from previous return
$
11. Additional credit (enter 3% of line 4)
$
12. Total of lines 7, 8, 9, 10 and 11
$
13. Tax due, if any (if line 5 exceeds line 12, enter difference here or line
3 if no advance payment was made)
$
14. Credit balance, if any (if line 12 exceeds line 5, enter difference
here and carry forward to line 10 of next return)
$
I declare under penalties of perjury that this return (including any accom-
Make check or money order payable to the
panying schedules and statements) has been examined by me and to the
Ohio Treasurer of State and mail to Ohio De-
best of my knowledge and belief is a true, correct and complete return and
partment of Taxation, P.O. Box 530, Columbus,
report.
OH 43216-0530. This return and payment
must be received on or before the 10th day
of the month following this reporting period.
Date
Authorized signature
If you have any questions regarding this return,
please call the Excise Tax Section at (855)
Telephone
466-3921.