Form Alc 210 - Cuyahoga County Wine And Mixed Beverage Tax Return
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1ALC 210
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Rev. 3/08
P.O. Box 530
Columbus, OH
43216-0530
Cuyahoga County Wine and Mixed Beverage Tax Return
Return is due on or before the last day of
the month following the reporting period.
For Department of Taxation
Reporting period
Use Only
Account number
Name
Address
City
State
ZIP
1. Gallons of wine and mixed beverages sold to Cuyahoga County retailers .............................
2. Gallons of wine and mixed beverages sold at retail in Cuyahoga County ..............................
3. Wine and mixed beverages tax (total of lines 1 and 2 multiplied by 32¢) ............................. $
4. Gallons of cider sold to Cuyahoga County retailers ................................................................
5. Gallons of cider sold at retail in Cuyahoga County .................................................................
6. Cider tax (total of lines 4 and 5 multiplied by 24¢) ................................................................ $
0.00
7. Gross tax (total of lines 3 and 6) ............................................................................................. $
8. Discount (.025 multiplied by line 7) ....................................................................................... $
9. Net tax (line 7 minus line 8) .................................................................................................... $
10. Late charge – $50 or 10% of line 7, whichever is greater ....................................................... $
0.00
11. Total amount due (line 9 plus line 10) .................................................................................... $
Make check or money order payable to the Ohio Treasurer of State and mail to Ohio Department of Taxation, P.O. Box 530,
Columbus, OH 43216-0530. This return and payment must be received by the last day of the month following the reporting period.
If you have any questions concerning the Cuyahoga County wine and mixed beverage tax, please contact the Ohio Department
of Taxation, Excise and Energy Tax Division, P.O. Box 530, Columbus, OH 43216-0530, or call toll-free (855) 466-3921.
I declare under penalties of perjury that this return, including any accompanying schedules and statements, has been
examined by me and, to the best of my knowledge and belief, is a true, correct and complete return and report.
Signature
Title
Date
Telephone
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