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 REPORT OF SALES INSTRUCTIONS WHO IS REQUIRED TO COMPLETE THIS REPORT? All licensed Kansas beer, wine and spirits distributors. DUE DATE: This monthly report is due on or before the 15th day of the calendar month following the month in which the distributor disburses alcoholic liquor. This report must be filed even if you have no sales to report. INSTRUCTIONS TO COMPLETE THE DISTRIBUTORS’ MONTHLY REPORT OF SALES: 1. Complete the month, year and your FEIN. 2. Complete distributor name, demographic and contact information. 3. Complete information listed for each invoice. If you have no sales to report, check the box “I do not have any sales to report this month”. EXPLANATION OF COLUMN HEADINGS: 1. No. Line number on form 2. Product Type. Enter the corresponding product type. AS = Alcohol and Spirits FW = Fortified Wine (14.1% ABV or more) LW = Light Wine (14% ABV or less) SB = Strong Beer SF = Flavored Malt Beverage – Strong ( 4% ABV or more) SW = Flavored Malt Beverage – Weak (4% ABV or less) WB = Cereal Malt Beverage (3.2% ABW or less) 3. Code. Enter the corresponding code. See Explanation of Codes below. 4. Buyer’s License/Permit Number. Enter the Kansas license number for the Kansas farm winery, microbrewery or manufacturer or corresponding universal license number. 5. Invoice Number. Enter the unique number that identifies the invoice. 6. Invoice Date. Enter the date of the invoice. 7. GTIN/SCC. Global Trading Identification Number. This is an optional field. 8. UNIMERC. Enter the number assigned by DISCUS or the brewery code. 9. Selling Units. Enter the items in the container. 10. Product Unit Size. Enter the size of the individual container. 11. Unit of Measure. Enter the size of the container measurement. 12. Shipment Quantity. Enter the quantity of selling units sold. 13. Shipment Unit of Measure. Enter the unit or basis of measurement shipped. Use only the following codes: BR (barrel); CA (case); EA (each); and PK (pack). 14. Unit Price. Enter the price of the individual selling units. EXPLANATION OF CODES: Use one of the following codes for entries in the Code column: 01 = Product Sold. Enter product information that is removed from the warehouse and sold to Kansas licensees. 02 = Out-of-State Transfers. Enter the products returned to the supplier or non-taxable sales of spirits to Military. 03 = Other Non-Taxable Distributions. This includes breakage, spoilage and shrinkage. 04 = Intrastate Transfers. Products sold to a licensed Kansas Distributor. 05 = Samples. Inventory withdrawn from the warehouse for samples. ABC-219 (Rev. 7.1.11) American LegalNet, Inc. www.FormsWorkFlow.com 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 REPORT OF SALES INSTRUCTIONS CONTINUED UNIVESAL LICENSE NUMBERS: When applicable, use one of the following universal license numbers in the Buyer’s License/Permit Number column: Breakage = 99-000-0000-01 Military Non-taxable Sales of Spirits Only = 99-000-0000-02 Military taxable sales = 99-000-0000-03 Spoilage = 99-000-0000-04 Cereal Malt Beverage Licensees = 99-XXX-0000-05. Replace the XXX with the three digit county code. Samples = Enter Your FEIN Shrinkage = 99-000-0000-06 USE OF LICENSE NUMBERS AND CODES: Code 1: Product Sold. Use the Kansas Licensee number, the universal Cereal Malt Beverage Number (99-XXX-0000-05) or the Military Taxable Sales Number (99-000-0000-03). Code 2: Out of State Transfers. Enter the Kansas Supplier Permit, manufacturer license number or the universal license number for Military non-taxable sales (99-000-0000-02). Code 3: Other Non-Taxable Distributions. Enter the universal license numbers for breakage (99-000-0000-01), spoilage (99-000-0000-04), or shrinkage (99-000-0000-06). Code 4: Intrastate Transfers. Enter the FEIN of the distributor to whom you are selling products. Code 5: Samples. Enter your FEIN. FILING OF DISTRIBUTORS’ MONTHLY REPORT OF PURCHASES: After completing all required information, file the Distributors’ Monthly Report of Purchases with the Kansas Department of Revenue. There are two methods to file this report: Electronically using EDI or filing a paper report. If you elect to file a paper report, only this form (ABC-219 and ABC-220 Rev. 7.1.11) will be accepted as all other versions (ABC-219 and ABC-220) are obsolete. If obsolete forms are filed, they will be rejected and returned to you. CONTACT INFORMATION: Questions may be directed to the ABC Marketing Unit. Phone: 785-296-7015 Email: ABC.Marketing.Unit@kdor.ks.gov ABC-219 (Rev. 7.1.11) American LegalNet, Inc. www.FormsWorkFlow.com KANSAS DEPARTMENT OF REVENUE ALCOHOLIC BEVERAGE CONTROL DIVISION 915 SW HARRISON TOPEKA, KANSAS 66625-3512 785-296-7015 MONTH: ________________________ YEAR: __________________________ FEIN: _________________________ DISTRIBUTORS’ MONTHLY REPORT OF SALES DISTRIBUTOR NAME: _______________________________________________________________________________________ PHONE: ________________________ ADDRESS: _____________________________________________________ CITY: _______________________________ KS ZIP CODE: ______________________ CONTACT PERSON: ______________________________________________ EMAIL ADDRESS: __________________________________________________________ I do not have any sales to report this month. No. Product Type Code Buyer’s License / Permit Number Invoice Number Invoice Date GTIN/SCC (Optional) UNIMERC Selling Units Product Unit Size Unit of Measure Shipment Quantity Shipment Unit of Measure Unit Price 1 2 3 4 5 6 7 8 9 10 11 12 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-219 (Rev. 7.1.11) Page 1 of _____ American LegalNet, Inc. www.FormsWorkFlow.com