Form Atg20121 - Oklahoma Mixed Beverage Tax Return 'Supplement'
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1
2ATG
20121
Revised 10-2012
Oklahoma Mixed Beverage Tax Return ‘Supplement’
A. Taxpayer FEIN/SSN
B. Reporting Period
C. Due Date
D. Account Number
E. Amended Return
H. Page ______ of _________ Page(s)
Mixed Beverage Sales
K. Site Total Gross Receipts
L. Taxable Admission Charges
I. Site Number
J. ABLE Number
M. Site Tax Due
(Whole numbers only)
(Whole numbers only)
Rate
13.5%
19
13.5%
20
13.5%
21
13.5%
22
13.5%
23
13.5%
24
13.5%
25
13.5%
26
13.5%
27
13.5%
28
13.5%
29
13.5%
30
13.5%
31
13.5%
32
33
13.5%
13.5%
34
13.5%
35
13.5%
36
13.5%
37
13.5%
38
13.5%
39
13.5%
40
13.5%
41
13.5%
42
13.5%
43
13.5%
44
13.5%
45
13.5%
46
13.5%
47
13.5%
48
13.5%
49
N. TOTAL
(add to Item N on Form ATG 20012,
Columns K and L and M)
If more space is needed, use supplemental page(s)
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