Atf Form 56305 - Special Tax Registration And Return (Nyc)
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4OMB NO. 1512-0472 ( 09/30/2002)
DEPARTMENT OF THE TREASURY
BUREAU OF ALCOHOL, TOBACCO AND FIREARMS
SPECIAL TAX REGISTRATION AND RETURN
ALCOHOL AND TOBACCO
(Please Read Instructions on Back Carefully Before Completing This Form)
SECTION I - TAXPAYER IDENTIFYING INFORMATION
1. EMPLOYER IDENTIFICATION NUMBER (Required see
2. BUSINESS TELEPHONE NUMBER
instructions)
FOR ATF USE ONLY
(
)
3. NAME (Last, First, Middle)
or
CORPORATE NAME (If Corporation)
T
FF
4. TRADE NAME
FP
5. MAILING ADDRESS (Street address or P.O. box number)
I
6. CITY
STATE
ZIP CODE
T
9. TAX PERIOD COVERING
ACTUAL LOCATION (IF DIFFERENT THAN ABOVE)
FROM:
7. PHYSICAL ADDRESS OF PRINCIPAL PLACE OF BUSINESS (Show street address)
(mm/dd/yy)
TO: June 30,
8. CITY
STATE
ZIP CODE
(yy)
SECTION II - TAX COMPUTATION
TAX CLASS DESCRIPTION (FOR ITEMS MARKED*, SEE INSTRUCTIONS)
MONTHLY
ANNUAL
LOCATIONS
TAX DUE
CODE
(a)
(b)
(c)
(d)
(e)
(f)
Liquors (Distilled spirits, wine or beer)
$250
11
$20.83
1 /
RETAIL
3
Beer only
$20.83
1 /
250
12
DEALER
3
Liquors (Distilled Spirits, Wine or Beer) - at large
250
15
$20.83
1 /
3
Beer only - at large
250
16
$20.83
1 /
3
Distilled spirits, wine or beer
$41.66
2 /
500
31
WHOLESALE
3
Beer only
500
32
$41.66
2 /
DEALER
3
Regular rate
1000
41
$83.33
1 /
BREWER
3
REDUCED rate*
$41.66
2 /
500
43*
3
NONBEVERAGE DRAWBACK CLAIMANT
500
51
User of specially denatured alcohol
250
55
$20.83
1 /
INDUSTRIAL
3
1 /
Dealer in specially denatured alcohol
$20.83
250
56
ALCOHOL
3
User of tax-free alcohol
250
57
$20.83
1 /
3
Proprietor of alcohol fuel plant
1000
58
$83.33
1 /
ALCOHOL
3
Proprietor of alcohol fuel plant - REDUCED*
$41.66
2 /
500
59*
PRODUCERS
3
Proprietor of distilled spirits plant
1000
81
$83.33
1 /
3
Proprietor of distilled spirits plant - REDUCED*
500
86*
$41.66
2 /
3
Proprietor of bonded wine cellar
$83.33
1 /
1000
82
3
Proprietor of bonded wine cellar - REDUCED*
500
87*
$41.66
2 /
3
Proprietor of bonded wine warehouse
1000
83
$83.33
1 /
3
Proprietor of bonded wine warehouse - REDUCED*
$41.66
2 /
500
88*
3
Proprietor of taxpaid wine bottling house
1000
84
$83.33
1 /
3
Proprietor of taxpaid wine bottling house - REDUCED*
500
89*
2 /
$41.66
3
Manufacturer of tobacco products
$83.33
1 /
1000
91
TOBACCO
3
Manufacturer of tobacco products - REDUCED*
500
95*
$41.66
2 /
PRODUCTS
3
Manufacturer of cigarette papers and tubes
1000
92
$83.33
1 /
3
2 /
Manufacturer of cigarette papers and tubes - REDUCED*
$41.66
500
96*
3
Proprietor of export warehouse
1000
93
$83.33
1 /
3
Proprietor of export warehouse - REDUCED*
500
97*
$41.66
2 /
3
MAKE CHECK OR MONEY ORDER PAYABLE TO "BUREAU OF ALCOHOL, TOBACCO AND FIREARMS", WRITE YOUR EMPLOYER
TOTAL TAX DUE $
IDENTIFICATION NUMBER ON THE CHECK AND SEND IT WITH THE RETURN TO BUREAU OF ATF, P.O. BOX 371962, PITTSBURGH,
0.00
PA 15250-7962.
Under penalties of perjury, I declare that the statements in this return/registration are true and correct to the best of my knowledge and belief; that this return/
registration applies only to the specified business and location or, where the return/registration is for more than one location, it applies only to the businesses at the locations specified on the
attached list. Note: Violation of Title 26, United States Code 7206, is punishable upon conviction by a fine of not more than $100,000 ($500,000 in the case of a corporation) or imprisonment
for not more than 3 years, or both, with the costs of prosecution added thereto.
SIGNATURE
TITLE
DATE
ATF F 5630.5 (10-99) PREVIOUS EDITIONS ARE OBSOLETE
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