Form Mt-39 - Alcoholic Beverages Tax Clearance Return For Tax On Importation Of Alcoholic Beverages Into New York State For Personal Consumption
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3MT-39
New York State Department of Taxation and Finance
Alcoholic Beverages Tax Clearance Return
(2/10)
For Tax on Importation of Alcoholic Beverages into
New York State for Personal Consumption
Name
Social security number
Identification type code
(see instructions)
Street address
City, town, or hamlet
State ZIP code
County
Daytime telephone
E-mail address
(
)
Location (city and country, or airport) where alcoholic beverages were purchased
Place of arrival in the U.S.
Date of arrival
If customs broker, complete the following:
Name
Street address
City, town, or hamlet
State ZIP code
Contact person
Telephone
E-mail address
(
)
Schedule A — Computation of the state and local sales tax
Complete Schedule B on page 2; then continue with Schedule A.
Note: Attach a copy of the airline or ship bill
( in English; translated if in another language).
A
B
Base for sales tax
New York taxes due
1 Total cost of alcoholic beverages, in U.S. dollars
1.
2 Federal excise tax
2.
( from Schedule B, column D, line 24)
3 State excise tax
3.
( from Schedule B, column F, line 24)
4 City excise tax
4.
( from Schedule B, column H, line 24)
5 Base for sales tax
5.
(add column A, lines 1 through 4)
6 Combined sales tax rate at your residence
(write
.0
.........................
6.
as a decimal, so 8¼% is .0825)
7 Sales tax due
............................
7.
( line 5 × line 6 )
8 Total tax due New York
8.
(add column B, lines 3, 4, and 7 )
Under penalty of perjury, I declare that this return is, to the best of my knowledge and belief, true, correct and complete and that all
beverages listed herein are for my personal use and consumption.
Signature of authorized person
Date
Signature of preparer
Date
Date of submission
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