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
DISTRIBUTORS’ MONTHLY GALLONAGE TAX RETURN
MONTH:_______________ YEAR: __________ FEIN: ___ ___ - ___ ___ ___ ___ ___ ___ ___
DISTRIBUTOR NAME:__________________________________________________________
ADDRESS: ___________________________________________________________________
CITY/STATE: ___________________________________________ ZIP CODE: ____________
CONTACT PERSON: ___________________________________________________________
EMAIL ADDRESS:_____________________________________________________________
PRODUCT TYPE:
CODE:
GALLONS:
TAX RATE:
TAX AMOUNT:
TAX DUE:
01
X
+
$
Alcohol and Spirits
$
$2.50 / Gallon
=
02
X
-
$
(GLAS)
03
X
-
$
01
X
+
$
Fortified Wine
$
$0.75 / Gallon
=
02
X
-
$
(14.1% ABV or more)
(FWGL)
03
X
-
$
01
X
+
$
Light Wine
$
$0.30 / Gallon
=
02
X
-
$
(14% ABV or less)
(LWGL)
03
X
-
$
01
X
+
$
Beer
$
$0.18 / Gallon
=
02
X
-
$
(4.1% ABV or more)
(GLBR)
03
X
-
$
Cereal Malt
01
X
+
$
Beverage
02
X
-
$
$
$0.18 / Gallon
=
(
3.2% ABW or less)
03
X
-
$
(MBTX)
Flavored Malt
01
X
+
$
Beverage - Strong
02
X
-
$
$
$0.18 / Gallon
=
(4.1% ABV or more)
03
X
-
$
(GFMB)
Flavored Malt
01
X
+
$
Beverage - Weak
02
X
-
$
$
$0.18 / Gallon
=
(
4% ABV or less)
03
X
-
$
(FMBT)
TOTAL GALLONAGE 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 whether individual owner, member of firm, or title if officer of corporation.
ABC-215 (Rev. 7.1.11)