FORM 315 2012 Maryland Direct Wine Shipper Tax Return 123150049 Direct Wine Shipper’s Name Federal Employer ID Number (FEIN) - Office Use Only Check Number___________ Street Address Amount $______________ City State ZIP code Deposit Date____________ E-mail Address Direct Wine Shipper’s Permit Number DW- For Calendar Quarter January – March April – June July – September October - December TAX DETERMINATION SUMMARY OF WINE / POMACE BRANDY SALES TO CONSUMERS IN MARYLAND DURING REPORT QUARTER I. TOTAL NUMBER OF GALLONS OF WINE SOLD TO CONSUMERS – TAX CALCULATION Convert Total Liters to Total Gallons by conversion factor of 0.264. One liter = 0.264 gallons. For example, one case of 750 ml bottles (12 bottles per case) = 9 liters x 0.264 = 2.376 gallons. 1. Conversion Calculation: Total Liters Sold by Case or Bottle: _________ x 0.264 = _________ Total Gallons Sold 2. Total Gallons Sold (from line 1):. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. ______________ 3. Adjustments:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. ______________ 4. Net Gallons subject to alcoholic beverage tax (line 2 plus or minus line 3) . . . . . . . . . . . . . . . . . . . . 4. ______________ 5. Wine tax per gallon. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. x 6. WINE TAX DUE (multiply line 4 by line 5). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. $______________ .40 II. Total number of gallons of Pomace Brandy sold to consumers - TAX CALCULATIONS Convert Total Liters to Total Gallons by conversion factor of 0.264. One liter = 0.264 gallons. For example, one case of 750 ml bottles (12 bottles per case) = 9 liters x 0.264 = 2.376 gallons. 7. Conversion Calculation: Total Liters Sold by Case or Bottle: _________ x 0.264 = _________ Total Gallons Sold 8. Total Gallons Sold (from line 7):. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. ______________ 9. Adjustments:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. ______________ 10. Net Gallons subject to alcoholic beverage tax (line 8 plus or minus line 9) . . . . . . . . . . . . . . . . . . . 10. ______________ 11. Pomace Brandy tax per gallon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. x 1.50 12. POMACE BRANDY TAX DUE (multiply line 10 by line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. $______________ 13. TOTAL TAX DUE (add line 6 and line 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. $______________ I do solemnly declare and affirm under the penalties of perjury that the contents of the foregoing document are true and correct to the best of my knowledge, information and belief. Print name_____________________________________________________________ Title: Owner, Partner or Officer____________________________________________ Signature _____________________________________________________________ Date__________________________________________________________________ COM/RAD-315 Rev. 08/12 American LegalNet, Inc. www.FormsWorkFlow.com Page 1 FORM 315 Maryland Direct Wine Shipper Tax Return Page 2 2012 123150149 Direct Wine Shipper’s Name A Date of Sale B Date of Shipment Federal Employer ID Number (FEIN) C Brand of Wine/ Pomace Brandy D Price Charged E Name of Consumer Shipped to - F Address of Consumer Shipped to G Total Liters Sold 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. In lieu of using this form to report each sale, a hard-copy report with the same information may be submitted. COM/RAD-315 Rev. 08/12 American LegalNet, Inc. www.FormsWorkFlow.com FORM 315 INSTRUCTIONS - maryland DIRECT WINE SHIPPER’S TAX RETURN Page 3 2012 This tax return, together with payment of the wine/pomace brandy tax due, shall be properly filed and physically received by the Revenue Administration Division no later than the 10th day of the month following the quarter in which wine/pomace brandy was sold and shipped to consumers in Maryland. Tax Period Due Date 12 Pomace Brandy tax due (multiply line 10 by line 11) 13 Total tax due (add line 6 and line 12) Page 2 – Each Wine/Pomace Brandy Sale to Consumers Column Line April 10th July 10th October 10th January 10th Payment shall be in the form of a check or money order payable to the “Comptroller of Maryland”. Page 1, Part I – Wine Tax Determination – Summary of Wine Sales to Consumers in Maryland Line A 1-14 Date of sale of wine/pomace brandy to consumer B 1-14 Date of shipment of wine/pomace brandy to consumer C 1-14 Brand of wine/pomace brandy sold. State name of each brand of wine/ pomace brandy and varietal sold D 1-14 Price charged E January – March April – June July – September October – December 1-14 Name of consumer shipped to on shipping label F 1-14 Address of consumer shipped to on shipping label G 1-14 Total liters of wine/pomace brandy sold to address of consumer shipped to 1 Convert total liters of wine sold to total gallons by multiplying amount by 0.264. For example, one case of 750 ml bottles (12 bottles per case) = 9 liters x 0.264 = 2.376 gallons 2 Total Gallons Sold (from Line 1) 3 Adjustments (if taking a debit or credit, please submit supporting documentation) This tax return must be signed by the owner, partner, or officer of the corporation. 4 Net gallons of wine subject to alcoholic beverage tax (Line 2 plus or minus Line 3 adjustments) If this is a corporation, an officer (President, Vice President, Secretary or Treasurer) must sign. 5 Maryland wine tax rate of $0.40 per gallon Mail tax return to: 6 Wine tax due (Multiply Line 4 by Line 5) Page 1, Part II - Pomace Brandy Tax DeterminationSummary of Pomace Brandy Sales to Consumers in Maryland “Pomace brandy” is defined as “brandy that is distilled from the pulpy residue of the wine press, including the skins, pips, and stalks of grapes.” 7 Convert total liters of Pomace Brandy sold to total gallons by multiplying amount by 0.264. For example, one case of 750 ml bottles (12 bottles per case) = 9 liters x 0.264 = 2.376 gallons 8 Net gallons of Pomace Brandy subject to alcoholic beverage tax (line 8 plus or minus line 9) 11 Telephone: 410-260-7690 or 1-800-638-2937 Fax: 410-260-7924 compnet.comp.state.md.us www.marylandtaxes.com Adjustments (if taking a debit or credit, please submit supporting documentation) 10 For more information: Total Gallons Sold (from Line 7) 9 Comptroller of Maryland Revenue Administration Division Returns Processing P.O. Box 2999 Annapolis, Maryland 21404 Maryland distilled spirit tax rate of $1.50 per gallon COM/RAD-315 Rev. 08/12 American LegalNet, Inc. www.FormsWorkFlow.com