Michigan Department of Licensing and Regulatory Affairs Liquor Control Commission (MLCC) Constitution Hall - 525 W. Allegan, Lansing, MI 48933 Mailing address: P.O. Box 30005, Lansing, MI 48909 Toll-Free: 866-813-0011 - www.michigan.gov/lcc Michigan Wine Tax Report (LCC-3890) InstructionsWho must file: A Michigan winery that sells wine in Michigan, a Michigan wholesaler that sells wine in Michigan, Michigan licensed direct shippers, and out-of-state licensed direct shipper licensees. A Michigan winery may designate a Michigan wholesale licensee as the taxpayer. However, the Michigan winery must still file wine tax reports and pay the taxes due for all wine sold or consumed at the licensed winery locations. When to file: Michigan wineries and Michigan wholesalers must file on a monthly basis, no later than the 15th of each month, whether or not any transactions have occurred. A new licensee must begin filing from the effective date of the license whether or not any product is registered. Direct shippers file wine tax reports QUARTERLY. Tax reports for direct shippers must be postmarked no later than April 15th, July 15th, October 15th, and January 15th, whether or not any transactions have occurred. A new licensee must begin filing from the effective date of the license whether or not any product is registered. What to include: Direct Shipper licensees must submit, along with the tax report, copies of all invoices for shipments to consumers in Michigan. ShipCompliant reports are acceptable instead of individual invoices. Michigan wineries must submit, in addition to the tax report, the Michigan Wine Maker or Small Wine Maker's Monthly Report of Sales (LCC-3860) and a copy of the monthly, quarterly, or annual Report of Wine Premises Operations form (TTB F 5120.17). Michigan wholesalers must submit, along with the tax report, copies of all invoices for wine sold in Michigan or, in the alternative, an Excel spreadsheet that contains all of the sales information from the individual invoices. Penalties: Any reports postmarked after the 15th of the month following the reporting period, missing reports, or missing tax payments will be subject to a $25 late charge and a 1% per month interest charge until the taxes are paid. A licensee who fails or refuses to submit a required report or who submits a false report, may be subject to a violation of the Liquor Control Code of 1998, which may result in the suspension or revocation of the license. Form Instructions If opened and used in Adobe Acrobat Reader, the form will automatically calculate the tax due based on the quantities and prorated tax rates inputted into the form Enter the business name, license number, address, and contact information. Indicate the month or quarter with the year for which the report is being filed. Locate appropriate pack size and enter total cases sold in the column under the correct percentage of alcoholic content by volume. Use the blank boxes for pack sizes and liters/cases that are not preprinted on the form. Enter the liters per case and the number of cases sold in the columns under the correct percentage of alcoholic content by volume . The tax rate for wine with 16% alcohol by volume or less is $0.135 per liter. The tax rate for wine with more than 16% alcohol by volume is $0.20 per liter. Use the attached additional pages if necessary. When calculating the tax owed, enter the amount of any MLCC authorized credits to be subtracted where indicated. Taxpayers must have MLCC approval prior to taking a credit on the tax report. Enter any penalties that you owe where indicated. Sign and date the form at the bottom of page 1. Pay the total tax due calculated. Make checks payable to State of Michigan/MLCC. QUESTIONS? Contact us at MLCCfinancewinetax@michigan.gov or call 517-284-6352.The attached LCC-3890 form will automatically calculate fees when opened using Adobe Acrobat Reader. The form's functionality may not work with third-party PDF readers. You may download a free copy of Adobe Acrobat Reader on the Adobe website: https://get.adobe.com/reader/ American LegalNet, Inc. www.FormsWorkFlow.com Michigan Department of Licensing and Regulatory Affairs Liquor Control Commission (MLCC) Constitution Hall - 525 W. Allegan, Lansing, MI 48933 Mailing address: P.O. Box 30005, Lansing, MI 48909 Toll-Free: 866-813-0011 - www.michigan.gov/lcc Michigan Wine Tax Report (LCC-3890) Month/Quarter & Year:Address:City, State & Zip Code: Fax number:Phone:Email: LARA is an equal opportunity employer/program. Auxiliary aids, services and other reasonable accommodations are available upon request to individuals with disabilities. Date Signature of Licensee Print Name of Licensee & TitleI certify that the information contained in this form is true and accurate to the best of my knowledge and belief. I also understand that providing false or fraudulent information is a violation of the Liquor Control Code pursuant to MCL 436.2003.DUE DATE: The 15th of the month following the month being reported. This report must be filed each month whether or not any transactions have occurred. Reports or payments postmarked after the 15th day of the reporting period will be subject to a $25.00 late charge and 1% interest.Page 1 of 3Total of Taxes Due:Less MLCC Authorized Credit:Shortage/Additional Taxes:Subtotal (MLCC Fee Code 4024):Penalty Payment(s) (MLCC Fee Code 4027):Total Payment Due:Make check payable to State of Michigan/MLCCIf necessary use additional pages to calculate tax on additional items.LCC-3890 (05-18)Case/Liter Tally Pack SizeLiters Per Case16% Alcohol or Less (Tax=$0.135/liter) More than 16% Alcohol (Tax=$0.20/liter) 4/5 Liter4/4 Liter4/3 Liter6/1.5 Liter12/1 Liter12/750 mL6/750 mL24/375 mL12/375 mL24/12 oz (355 mL)48/187 mL24/187 mL# of CasesTotal Liters# of CasesTotal LitersSubtotal A:Subtotal B: Subtotal A Liters:+ Additional Page(s) Subtotal A Liters:x $0.135 per Liter Tax Rate =Subtotal B Liters:+ Additional Page(s) Subtotal B Liters:x $0.20 per Liter Tax Rate =16% Alcohol or Less Tax DueMore Than 16% Alcohol Tax Due MLCC License Number:MLCC Licensee Name: American LegalNet, Inc. www.FormsWorkFlow.com Michigan Wine Tax Report (LCC-3890) - Additional Page 1 (Use If Necessary)Business Name:Month/Quarter & Year:License Number: LARA is an equal opportunity employer/program. Auxiliary aids, services and other reasonable accommodations are available upon request to individuals with disabilities. Page 2 of 3 Subtotal A:Subtotal B:Case/Liter Tally Pack SizeLiters Per Case16% Alcohol or Less (Tax=$0.135/liter) More than 16% Alcohol (Tax=$0.20/liter) # of CasesTotal Liters# of CasesTotal Liters LCC-3890 (05-18) American LegalNet, Inc. www.FormsWorkFlow.com Michigan Wine Tax Report (LCC-3890) - Additional Page 2 (Use If Necessary)LARA is an equal opportunity employer/program. Auxiliary aids, services and other reasonable accommodations are available upon request to individuals with disabilities. Page 3 of 3 Business Name:Month/Quarter & Year:License Number: Subtotal A:Subtotal B:Case/Liter Tally Pack SizeLiters Per Case16% Alcohol or Less (Tax=$0.135/liter) More than 16% Alcohol (Tax=$0.20/liter) # of CasesTotal Liters# of CasesTotal Liters LCC-3890 (05-18) American LegalNet, Inc. www.FormsWorkFlow.com