Form Alc 120 - Brand Registration Renewal Return
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1
2TENNESSEE DEPARTMENT OF REVENUE
Brand Registration Renewal Return
Account No.
Taxable Period
SSN OR FEIN
ALC
Beginning:
120
Due Date
Ending:
}
If this is an AMENDED RETURN,
please check the box at right
Make your check payable to the Tennessee Department
of Revenue for the amount shown on Line 8 and mail to:
TENNESSEE DEPARTMENT OF REVENUE
Andrew Jackson State Office Building
500 Deaderick Street, Nashville TN 37242
Should you need assistance, please contact the Taxpayer
Services Division by calling our statewide number
(800) 342-1003 or (615) 253-0600.
ROUND TO NEAREST DOLLAR
WRITE NUMBERS LIKE THIS
1. Number of brands of distilled spirits with Tennessee wholesale sales of 50 cases or more during the
(1)
.00
previous year..................................................................................(1a).__________ x $___250___.....
00
.
2. Number of brands of distilled spirits with Tennessee wholesale sales of less than 50 cases during the
previous year..................................................................................(2a).__________ x $___100___.....
(2)
00
.
3. Number of brands of wine with Tennessee wholesale sales of 250 cases or more during the
(3)
previous year..................................................................................(3a).__________ x $___250___.....
00
.
4. Number of brands of wine with Tennessee wholesale sales of less than 250 cases during the
(4)
0
0
0
0
0 0
0
0
00
.
previous year................................................................................(4a).__________
.............................
5. Brand Registration Tax (Add Lines 1, 2, and 3, and enter here).........................................................
(5)
00
.
6. Penalty (See instructions)....................................................................................................................
(6)
00
.
7. Interest
% (See instructions)......................................................................................................
(7)
00
.
8. Total Amount Due (Add Lines 5, 6, and 7, and enter here).................................................................
(8)
00
.
I declare this is a true, complete, and accurate return to the best of my knowledge.
FOR OFFICE USE ONLY
SIGN
HERE
President or other Principal Officer, Partner, or Proprietor
Date
SIGN
HERE
Tax Return Preparer and Title
Date
RV-F0012501
INTERNET (08-11)
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