Form Alc 84 - Ohio Beer And Malt Beverage Monthly Advance Tax Payment
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1ALC 84
Reset Form
Rev. 9/06
P.O. Box 530
Columbus, OH
43216-0530
Ohio Beer and Malt Beverage Monthly Advance Tax Payment
For Department of
Advance payment for the month of
20
Taxation Use Only
Month
Year
Advance payment is enclosed in the amount of $
Account number
Permittee name
Date
Authorized signature
Make check or money order payable to Ohio Treasurer of State and mail to the Ohio Depart-
ment of Taxation, P.O. Box 530, Columbus, OH 43216-0530.
If this form is received by the Ohio Department of Taxation and the amount shown thereon is paid on or before the 18th
day of the month for which the estimate is made, the taxpayer is entitled to an additional credit of 3%. This 3% shall not be
deducted from the amount of the advance payment, but instead shall be computed as an additional credit on line 11 of the
monthly return (form ALC 83).
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