Form R-1-W - Alcoholic Beverage Tax
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R-1-W
(Rev. 04-12) CONTROL SHEET
DO NOT WRITE IN THIS SPACE
STATE OF NEW JERSEY
ALCOHOLIC
DEPARTMENT OF THE TREASURY
BEVERAGE TAX
DIVISION OF TAXATION
WINERY MANUFACTURER’S TAX SALES REPORT FOR PERIODS BEGINNING ON AND AFTER MAY 1, 2012
Submit Control Sheet, all necessary schedules and an extra copy of Schedule “E” to the: Division of Taxation, Revenue Processing Center,
PO Box 241, Trenton, New Jersey 08646-0241. Also, copies of the Federal ATF Forms 5120.17 (702), for the two months noted below, must be submitted.
Check one:
Winery is located outside New Jersey
Winery is located inside New Jersey
_________________________________________________________, ________________________________________________________
(PRINT THE LICENSEE NAME HERE)
(FEDERAL IDENTIFICATION NUMBER)
_________________________________________________________, ________________________________________________________
(PRINT TRADE NAME HERE, IF ANY)
(STREET ADDRESS)
_________________________________________________________, ________________________________________________________
(CITY, STATE, ZIP)
(COUNTY)
__________________________________________________________________________________________________________________
(PRINT MAILING ADDRESS IF DIFFERENT FROM ABOVE, SEE INSTRUCTION)
________________________________
)_____________________________
the holder of
License No.(s
under Title 33 of the Revised Statues,
(TYPE OF LICENSE(S) SEE INSTRUCTION)
__________________
__________________,
_________
as amended, reports business transacted during the Bimonthly Period of
and
year
, as follows:
Apple Cider*
Still Wines
Sparkling Wines
(3.2% to 7% Alcohol)
For Full Particulars,
Sales to NJ
Direct Ship to
Sales to NJ
Direct Ship to
See Instructions
Retailers
NJ Consumer
Retailers
NJ Consumer
Total Wine Gallons
Total Wine Gallons
Total Wine Gallons
Total Wine Gallons
Total Wine Gallons
1. Taxable sales, etc. “D-W”
2. Exemption claimed per “E”
3. Sub-total (Item 1 plus 2)
4. Sales and returns per “A”
5. Total (item 3 plus 4)
COMPUTATION OF TAXES DUE AND PAYABLE WITH THIS REPORT
6. Tax due sales
(Repeat Item 3)
7. Exemption taken per “F”
8. Balance (Item 6 minus 7)
9. Tax Credit per “H-3”
10. Net taxable sales
(Item 8 minus 9)
11. Tax rates
$0.875
$0.875
$0.875
$0.875
$0.15
12. Tax due
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 months for failure to submit a
Tax Due (Total of Item 12) . . . . . . . . . . . . . . . . $__________________
complete return, including schedules, by the required filing date. A separate penalty of 5%
is required for late payments. Interest is computed at 3% over the prime rate on the unpaid
Beverage Tax Credit Memos. Numbers . . . . . . $__________________
balance. At the end of each calendar year, any tax, penalties and interest remaining due will
become part of the balance on which interest is charged. In addition, a $100 penalty may
Transmitted herewith in payment of taxes due . $__________________
be added for each month that the report is late.
Pursuant to the provisions of Title 54 of the Revised Statutes, as amended and supplemented,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 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.
*Apple cider containing more than 7% alcohol to be included under Sparkling Wines. Apple Cider containing 3.2% to 7% alcohol to be included under Apple Cider.
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