Form Abc-206 - Individual'S Gallonage Tax Return For Alcoholic Liquor Transported From Within The United States Into Kansas Page 2

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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
INDIVIDUAL’S GALLONAGE TAX RETURN FOR ALCOHOLIC LIQUOR
TRANSPORTED FROM WITHIN THE UNITED STATES INTO KANSAS
PART A – GALLONAGE TAX RETURN
As required by K.S.A. 41-104(a) and 41-501(b)(2)
NAME: ________________________________________________SSN: _____________________
PHONE: _______________________________________________FAX: _____________________
EMAIL ADDRESS:________________________________________________________________
TRANSPORTING FROM ADDRESS: __________________________________________________
City
State
TRANSPORTING TO ADDRESS: _____________________________________________________
City
State
TRANSPORTATION DATE(S): _______________________________________________________
PRODUCT TYPE:
NUMBER OF
TAX RATE PER
TAX AMOUNT:
WHOLE
GALLON:
GALLONS:
Alcohol and Spirits
X
$2.50
=
$
(IGAS)
Beer
X
$0.18
=
$
(IGBR)
Flavored Malt Beverage – Strong
X
$0.18
=
$
(IFMB)
Fortified Wine
X
$0.75
=
$
(IGFW)
Light Wine
X
$0.30
=
$
(IGLW)
TOTAL GALLONAGE TAX DUE =
$
I have calculated the Kansas Gallonage Tax imposed by K.S.A. 41-501 et seq for the alcoholic liquor
listed above that I have previously purchased and/or possessed within the borders of the United
States and am now transporting into the State of Kansas. I certify that this alcoholic liquor is for the
personal use of my family, my guests and myself and not for resale within the State of Kansas.
Attached is my check, bank draft or money order payable to the “Kansas Department of Revenue”.
I declare under penalties of perjury that to the best of my knowledge and belief this is a true, correct
and complete return.
Signature
Date
ABC USE ONLY:
Approved By
Date
ABC-206 (Rev. 7.1.11)

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