Form Abc-173 - Return Keg Tags
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1Kansas 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
RETURN KEG TAGS
Please complete and return this form when returning unused keg tags to the Alcoholic Beverage Control.
Check one:
Retail Liquor Store
Microbrewery
Cereal Malt Beverage Retailer
Military Retailer
Retailer Information:
Owner Name:
DBA Name:
License Number / CMB Stamp Number / ATF Number:
Address:
City / State / Zip:
Phone:
Fax:
Mailing Information:
(if different from retailer address)
Name:
Address:
City / State / Zip:
Keg Tag Information:
Tag Number(s) Returned:
Quantity:
Name of Person Returning Keg Tags:
___________________________________________________________________________
Signature of Person Returning Keg Tags
Date
ABC Office Use Only:
Keg Tag Numbers Returned to Inventory:
Quantity Returned:
Date Returned to Inventory:
Completed By:
ABC-173 (Rev. 7.1.11)
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Parent category: Financial