Arizona Form 815 - Wholesalers Return Of Spirits Sold/vinous And Malt/cider Liquor Purchased - 1997

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Arizona Department of Revenue
ARIZONA FORM
815
Comptroller Section
1600 W Monroe, Site Code 603
Phoenix AZ 85007
Wholesalers Return of Spirits Sold/Vinous and Malt/Cider Liquor Purchased
For the Month of ________________________________________ 19 _____
This return and the tax shown is due not later than the 20th day of the month following the month for
which this return is made and delinquent if the tax is not paid within 10 days after the due date.
Licensed wholesaler - name
Liquor license no.
Taxpayer ID (EIN or SSN)
Address - mailing
Address - business location
City
State
ZIP code
City
State
ZIP code
File Separate Return for Each License
Read Instructions Prior to Completing Return
A
C
B
Spirits
Malt/Cider
Vinous
Gallons
Gallons
Gallons
1. Beginning Inventory (same as ending inventory of prior month) ..
2. Additions - total gallons
a. Received/purchased this month - Schedule A .......................
b. Returned from retailers ..........................................................
3. Total Additions (2a + 2b) ..............................................................
4. Deductions - total gallons
a. Sold to Military Installations - Schedule B ..............................
b. Exported from State - Schedule C .........................................
c. Sold to Arizona wholesalers - Schedule D .............................
d. Purchased from Arizona wholesalers - Schedule D ..............
e. Destroyed ..............................................................................
f. Breakage ...............................................................................
g. Returned to suppliers .............................................................
h. Returned from retailers ..........................................................
5. Total Deductions (4a through 4h) ................................................
6. Other adjustments, gain or loss ...................................................
7. Ending Inventory ..........................................................................
8. Taxable gallons sold/purchased ..............................................
9. Tax Rates ....................................................................................
$.84
$.16
$3.00
10. Tax Due .......................................................................................
$
$
$
11. Total Tax Due $ _____________________________
Declaration of preparer (other than taxpayer) is based on all information of
I have read this report and any attachments with it. Under penalties of perjury, I
which preparer has any knowledge.
declare that to the best of my knowledge and belief, they are correct and
Preparer's Signature
Taxpayer's/Authorized Agent's Signature
Preparer's TIN
Date
Title
Date
ADOR 20-2048 (7/97)

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