Form Rb-1 - Beverage Tax Manufacturer'S Tax Sales Report Restricted Brewery

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RB-1
STATE OF NEW JERSEY
(9-07)
DO NOT WRITE IN THIS SPACE
DEPARTMENT OF THE TREASURY
CONTROL SHEET
DIVISION OF TAXATION
BEVERAGE TAX
MANUFACTURER’S TAX SALES REPORT
RESTRICTED BREWERY
Pursuant to the provisions of N.J.S.A. 54:43-1, et seq., submit to the Division of Taxation, Revenue Processing Center, PO Box 241,
Trenton, NJ 08646-0241, this report and a complete copy of Federal Form ATF 5130.9.
_______________________________________________________
____________________________________________________
(PRINT LICENSEE NAME)
(FEDERAL IDENTIFICATION NUMBER)
_______________________________________________________
____________________________________________________
(PRINT TRADE NAME, IF ANY)
(STREET ADDRESS)
_______________________________________________________
____________________________________________________
(CITY, STATE, ZIP)
(COUNTY)
______________________________________________________________________________________________________________
(PRINT MAILING ADDRESS IF DIFFERENT FROM ABOVE)
the holder of a Restricted Brewery License, License No. _________________________________ under Title 33 of the Revised Statutes,
as amended, reports business transacted during the bimonthly period of _________________________________________ and
____________________________________________, (year)_______________, as follows:
Beer and Malt Beverages
COMPUTATION OF TAXES DUE AND PAYABLE WITH THIS REPORT
Total Gallons
1. Taxable sales removed for consumption etc. per ATF Form 5130.9, line 15 column (f).
Report in gallons. Convert barrels to gallons by multiplying the number of barrels by 31.
Round to the next higher whole gallon.
2. Tax rate per gallon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
0.12
3. Tax due (line 1 x line 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
Title 54 of the Revised Statutes, as amended and supplemented, provides
for a penalty based on the tax of 5% per month up to a maximum of five
Tax due . . . . . . . . . . . . . . . . . . . $ _____________________
months for failure to submit a complete return including schedules by the
required filing date. A separate penalty of 5% may be imposed for late
Beverage Tax Credit . . . . . . . . . $ _____________________
payments. Interest is computed at 3% above the prime rate for every
month or fraction of a month the tax is unpaid. At the end of each calendar
Memo Number _____________
year, any tax, penalties and interest remaining due will become part of the
balance on which interest is charged. Added to the penalties based on the
Transmitted herewith in
tax is a penalty of $100 per month for each month the return is late.
payment of taxes due . . . . . . . . $ _____________________
This report shall cover two calendar months’ business from the first to the last of the two month period inclusive, and shall be signed by the
licensee, or the proper officer if the licensee is a corporation or by the duly authorized agent of the licensee. The report with schedules and
check or money order (no stamps) for the amount of taxes due shall be filed with the Division of Taxation, Revenue Processing Center, PO
Box 241, Trenton, NJ 08646-0241, within FIFTEEN DAYS after the expiration of the period reported upon. Beverage Tax Reports shall be
filed covering each bimonthly period or part of a period that a license is in force even though during the period no business is transacted
under the license.
I certify under the penalties provided by law, including license suspension or revocation, that this report, (including any accompanying schedules
and statement(s)) has been examined by me and is true, correct and complete. I also certify that I am the person authorized to certify this report.
______________________________________________________ ( _______ ) ___________________ ________________________
SIGNATURE OF LICENSEE OR AUTHORIZED AGENT
PHONE
DATE
________________________________________ ( _______ ) ______________ __________________________ ________________
SIGNATURE OF INDIVIDUAL OR FIRM PREPARING RETURN
PHONE
FEDERAL IDENTIFICATION NUMBER
DATE
PENALTIES FOR FAILURE TO FILE REPORT, OR FILING OF FALSE OR FRAUDULENT REPORT.
Any person who shall fail to file any report required to be filed pursuant to the provisions of this title, or shall file or cause to be filed, with the Director,
any false or fraudulent report or statement, or shall aid or abet another in the filing with the Director, any false or fraudulent report or statement, with the
intent to defraud the State or evade the payment of any tax, penalty or interest or any part thereof, which shall be due pursuant to the provisions of this title,
shall be punished in accordance with the State Tax Uniform Procedure Law, R.S. 54:48-1 et seq.

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