Form Abc-1025 - Microbrewery Monthly Gallonage Tax Return And Sales Report Page 3
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4Kansas 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
MICROBREWERY MONTHLY GALLONAGE TAX RETURN AND SALES REPORT
MONTH:_______________ YEAR: __________ FEIN: ___ ___ - ___ ___ ___ ___ ___ ___ ___
MICROBREWERY NAME:________________________________________________________________________
ADDRESS: ___________________________________________________________________________________
CITY: ________________________________________________________, KS
ZIP CODE: _______________
CONTACT PERSON: ___________________________________________________________________________
EMAIL ADDRESS:_____________________________________________________________________________
No domestic beer was brewed this month.
No malt products were manufactured, used, sold, stored or purchased this month.
Gallonage tax credit carried forward. Amount: $________________
GALLONS /
PRODUCT TYPE:
CODE:
TAX RATE:
TAX AMOUNT:
TAX DUE:
POUNDS:
01
X
+ $
Domestic Beer
02
X
$0.18 / Gallon
-
$
= $
(3.2%-10% ABW)
(DOBE)
03
X
-
$
+ $
04
+
Wort or Liquid Malt
$0.20 / Gallon
= $
$
(WALM)
05
-
-
+ $
Malt Syrup or Malt Extract
04
+
$0.10 / Pound
= $
$
05
-
-
(MASE)
$
Tax Amount =
$
Credit From Previous Report Period -
TOTAL TAX DUE =
$
I have paid my gallonage tax using the EFT option.
I declare under penalties of perjury that to the best of my knowledge and belief this is a true, correct and complete return.
SIGNATURE ____________________________________________TITLE ________________________________________________
State if individual owner, member of firm, or title if officer of corporation.
CODES:
01 = Total Gallons of Domestic Beer Brewed
02 = Sales to Out-of-State Wholesalers
03 = Sales to Non-Beverage Permit Holders
04 = Taxable Ingredient Purchased/Manufactured
05 = Taxable Ingredient Used to Manufacture Domestic Beer
Page 3 of 4
ABC-1025 (7.1.12)
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