Form Abc-20 - Individual'S Gallonage Tax Return Wine Purchased In Person At Any Out-Of-State Winery Page 3
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3Kansas Department of Revenue
Alcoholic Beverage Control Division
915 S.W. Harrison Street, Room 214
Topeka, KS 66625-3512
Phone: 785-296-7015 Fax: 785-296-7185
INDIVIDUAL’S GALLONAGE TAX RETURN
WINE PURCHASED IN PERSON ANY OF OUT-OF-STATE WINERY
PART B - ITEMIZED LIST OF WINE PURCHASED
NAME: ____________________________________________________________SSN: _____________________
ADDRESS: __________________________________________________________________________________
City
State
PHONE: ___________________________________________ FAX: ____________________________________
Number
Purchase
Product
No.
Winery Name
Product Name
Size
Quantity
of
Date
Type *
Gallons
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* PRODUCT TYPE:
FW = Fortified Wine (14.1% ABV or more)
LW = Light Wine (14% ABV or less)
ABC-207 (Rev. 7.1.11)
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