Form Lb40 - Malt Beverages Excise Tax Return
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3LB40
Malt Beverages Excise Tax Return
Due by the 18th of the month following the period in which the shipments of beer were received, even if no tax is due.
Check if amended
Company Name
FEIN
Address
Minnesota Tax ID Number
Location Code
City
State
ZIP Code
Period of Return
A
B
More Than 3 .2%
3 .2% or Less
(in barrels; see instructions)
(in barrels; see instructions)
1 Untaxed shipments of beer received (from Schedule A;
include partial barrels) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Miscellaneous credits or reductions (from Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . 2
3 Breakage (from Schedule C) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Subtotal. Add lines 2 and 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5 Amount of beer subject to tax (subtract line 4 from line 1) . . . . . . . . . . . . . . . . . . . . . 5
$4.60
$2.40
6 Tax rates per barrel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
7 Multiply line 5 by line 6 in each column . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 $
$
8 Add line 7, columns A and B. This is your TOTAL TAX DUE (see instructions for payment options) . . . . . . . . . . . 8 $
Check method of payment:
Electronic payment
Check
(make payable to Minnesota Revenue)
I declare that this return and accompanying schedules are correct and complete to the best of my knowledge and belief.
Authorized Signature
Date
Daytime Phone
Print Name
Title
Paid Preparer’s Signature
PTIN
Date
Daytime Phone
Mail to: Minnesota Revenue, Mail Station 3331, St. Paul, MN 55146-3331
Phone: 651-556-3036 Fax: 651-556-5236 Email: alc.taxes@state.mn.us
(Rev. 9/14)
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