LB41 Excise Tax Return for Brewers Due by the 18th of the month following the period in which the sales were made, even if no tax is due. Check if amended Company Name FEIN Minnesota Tax ID Number State ZIP Code Period of Return Location Code Print or Type Address City More Than 3.2% (in barrels; see instructions) A 3.2% or Less (in barrels; see instructions) B 1 Shipments of beer to Minnesota wholesalers (from Schedule A) . . . . . . . . . . 1 2 Return from Minnesota wholesaler (from Schedule B) . . . . . . . . . . . . . . . . . . 2 Determining Tax 3 Miscellaneous credits or reductions (from Schedule C) . . . . . . . . . . . . . . . . . . 3 4 Total deductions (add lines 2 and 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 5 Total taxable shipments to Minnesota wholesalers (subtract line 4 from line 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 6 Tax rates per barrel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 7 Multiply line 5 by line 6 in each column . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 8 Add amounts on line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 $ 9 Qualified brewer credit (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 $ 10 TOTAL TAX DUE (subtract line 9 from line 8) (see instructions for payment options) . . . . . . . . . . . . . . 10 $ Check method of payment: Electronic payment Check (make payable to Minnesota Revenue) $4.60 $2.40 I declare that this return and accompanying schedules are correct and complete to the best of my knowledge and belief. Authorized Signature Date Title PTIN Date Daytime Phone Daytime Phone Sign Here (Rev. 9/14) Print Name Paid Preparer's Signature Mail to: Minnesota Revenue, Mail Station 3331, St. Paul, MN 55146-3331 Phone: 651-556-3036 Fax: 651-556-5236 Email: alc.taxes@state.mn.us American LegalNet, Inc. www.FormsWorkFlow.com LB41 Company Name Period of Return FEIN Minnesota Tax ID Number Location Code Shipments to Minnesota Wholesalers List the shipments of beer sold to Minnesota wholesalers during the period. Invoice Date Number Sold To More Than 3.2% (in barrels) Schedule A 3.2% or Less (in barrels) Total (enter on Form LB41, line 1) Return from Minnesota wholesalers List any returned beer sold to Minnesota wholesalers. Date Sold To Reason More Than 3.2% (in barrels) Schedule B 3.2% or Less (in barrels) Total (enter on Form LB41, line 2) Miscellaneous Credits or Reductions Schedule C List any credits or reductions, such as sales for shipments out of Minnesota, sales to common carriers engaged in interstate transportation of passengers, sales to qualified approved military clubs and authorized breakage and destruction. Date Wholesaler Reason More Than 3.2% (in barrels) 3.2% or Less (in barrels) Total (enter on Form LB41, line 3) American LegalNet, Inc. www.FormsWorkFlow.com Form LB41 Instructions File the original Form LB41 with the Department of Revenue and keep a copy for your records. Copies and supporting records must be saved for a minimum of 3½ years. thereof) to a maximum of 15 percent. Returns filed after the due date will be assessed a 5 percent late-filing penalty on any unpaid tax, or if no tax is due a penalty of $25 is assessed for each unfiled return. Interest will accrue on any unpaid tax and penalty. commonly used sizes of kegs and cases. Multiply the number you have of each size by the decimal shown. General Instructions Brewers or any person who imports, or directly or indirectly sells beer to Minnesota wholesalers must file a return and pay fermented malt beverages tax. Monthly filing is mandatory if your tax averages $500 or more per month. You must request, in writing, authorization to file annually or quarterly. The authorization remains in effect as long as the tax remains within the limits stated below. · Annual filing. Tax must average less than $100 per month. · Quarterly filing. Tax must average less than $500 per month. · Monthly filing. Tax must average $500 or more per month. Monthly manufacturer's warehouse report. If you have a manufacturer's warehouse permit under M.S. 340A.3055, you must complete Form LB41-MW, Manufacturer's Minnesota Warehouse Report, each month and attach it when you file your Form LB41. Conversion table If you have: Payment Options Electronic Payments If you paid more than $10,000 in Minnesota excise taxes during the last 12-month period ending June 30, you are required to make your payments electronically. You must also pay electronically if you're required to pay any Minnesota business tax electronically, such as sales and withholding taxes. Go to www.revenue.state.mn.us and log in to e-services. If you don't have Internet access, you can pay by phone at 1-800-570-3329. You'll need your bank routing and account numbers. You must use an account not associated with a foreign bank. Note: If you're currently paying electronically using the ACH credit method, continue to call your bank as usual. If you wish to make payments using the ACH credit method, instructions are available at www.revenue.state.mn.us. Multiply the quantity you have by: 50 ltr bbl 30 ltr bbl 6/64 oz. case 12/40 oz. case 12/32 oz. case 24/22 oz. case 15/22 oz. case 12/22 oz. case 24/16 oz. case 12/16 oz. case 30/12 oz. case 24/12 oz. case 20/12 oz. case 18/12 oz. case 12/12 oz. case 6/12 oz. case 24/11.2 oz. case 35/7 oz. case 12/21.3 oz. case .42608 .25565 .09677 .12097 .09677 .13306 .08317 .06653 .09677 .04839 .09073 .07258 .06048 .05444 .03629 .01815 .06774 .06174 .06441 Line 9 To qualify for this credit, you must be a brewer who, in the last calendar year, produced less than 250,000 barrels of all brands or labels of beer. All facilities for producing beer owned or controlled by the same person, corporation or other organization count as a single brewer. Brewers earn the credit during the calendar year and use the credit in the following fiscal year. For instance, the credit on barrels produced Jan. 1, 2012 through Dec. 31, 2012 are used July 1, 2013 through June 30, 2014. Qualified brewers are entitled to a tax credit of $4.60 per barrel up to 25,000 barrels, or $115,000, regardless of the alcohol content of the beer. In the fiscal year, the total credit claimed can't exceed the tax owed or $115,000, whichev