ALC 50012
Revised 10-2011
Oklahoma Winemakers Inventory of Wine and Sparkling Wine
Check Here if
Amended Return:
Oklahoma Tax Commission
2501 North Lincoln Boulevard
Oklahoma City, OK 73194
Taxpayer FEIN/SSN
Month and Year of Return
OTC Permit Number
ABLE License Number
_______________________________________________________________________
Name of Winery
_______________________________________________________________________
Address
_________________________________________________________
__________
_______________________________
City
State
Zip
This return must be submitted no later than the tenth (10th) of the month covering all transactions in detail for the previous month. Attach
invoices, credit memos, and credit documentation for all transactions, including non-taxable. For more details, please see instructions.
Report in Liters (carry to 3 decimal places)
Wine
Sparkling Wine
1.
Beginning Inventory of Saleable Beverages
2.
Wine Produced (include wine purchased as produced)
a.
Short Shipments/Returns to Inventory
3.
Available (add lines 1, 2 and 2a)
4.
Inventory Disposition - Taxable
a.
On Premises Winery Sales
b.
Samples Consumed/Distributed
c.
Sales to Oklahoma Wholesalers
d.
Sales to Oklahoma Retailers
e.
Sales to Mixed Beverage Permittees
f.
Sales for Export Out-of-State
g.
Total (add lines 4a, 4b, 4c, 4d, 4e and 4f)
5.
Inventory Disposition - Non Taxable
a.
Sacramental Wine
b.
Bond to Bond Transfers In/Out (+/-)
c.
Total (add lines 5a and 5b)
6.
Unsaleable Destroyed
a.
Destroyed Unsaleables
7.
Ending Inventory Per Return (Subtract lines 4g, 5c and 6a from line 3)
I the undersigned or duly authorized agent, state under the penalties of perjury that this return with accompanying schedules which are made part hereof, is
to the best of my knowledge and belief true and correct.
Official Title
Signature
Date