Kansas 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 FOR ALCOHOLIC LIQUOR
TRANSPORTED FROM OUTSIDE THE UNITED STATES INTO KANSAS
PART A – GALLONAGE TAX RETURN
As required by K.S.A. 41-104(a) and 41-501(b)(2)
NAME: ________________________________________________SSN: ______________________
PHONE: _______________________________________________FAX: ______________________
EMAIL ADDRESS:_________________________________________________________________
TRANSPORTING FROM ADDRESS: __________________________________________________
City
State
Country
TRANSPORTING TO ADDRESS: _____________________________________________________
City
State
Country
TRANSPORTATION DATE(S): _______________________________________________________
ONE GALLON
NUMBER
TAX RATE
EXEMPTION
PRODUCT TYPE:
OF WHOLE
PER
SUBTOTAL
TAX AMOUNT:
(Subtract only one
GALLONS:
GALLON:
product type)
Alcohol and Spirits
X
$2.50
=
$
-
$2.50
=
$
-2.50
(IGAS)
X
$0.18
=
$
-
$0.18
=
$
Beer
-0.18
(IGBR)
Flavored Malt Beverage –
X
$0.18
=
$
-
$0.18
=
$
-0.18
Strong
(IFMB)
Fortified Wine
X
$0.75
=
$
-
$0.75
=
$
-0.75
(IGFW)
Light Wine
X
$0.30
=
$
-
$0.30
=
$
-0.30
(IGLW)
TOTAL GALLONAGE TAX DUE =
-3.91
$
I have calculated the Kansas Gallonage Tax imposed by K.S.A. 41-501 et seq for the alcoholic liquor listed
above that I have previously purchased and/or possessed outside of the United States and am now
transporting into the State of Kansas. I certify that this alcoholic liquor is for the personal use of my family,
my guests and myself and not for resale within the State of Kansas.
Attached is my check, bank draft or money order payable to the “Kansas Department of Revenue”.
I declare under penalties of perjury that to the best of my knowledge and belief this is a true, correct and
complete return.
Signature
Date
ABC USE ONLY:
Approved By
Date
ABC-205 (Rev. 7.1.11)