Carriers Alternative Mixed Beverage Tax Return
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Carriers Alternative Mixed Beverage Tax Return Form. This is a Virginia form and can be use in Department Of Alcoholic Beverage Control Statewide.
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Tags: Carriers Alternative Mixed Beverage Tax Return, Virginia Statewide, Department Of Alcoholic Beverage Control
COMMONWEALTH OF VIRGINIA
DEPARTMENT
OF
ALCOHOLIC
BEVERAGE
CONTROL
BOX 27491
P. 0.
RICHMOND,
VIRGINIA 23261
(Submit in triplicate on
or before Oct. 30,
QUARTER ENDING:
CARRIER'S ALTERNATIVE MIXED BEVERAGE TAX RETURN
,20
Jan 30,
July 30.)
(Section 4.1-221, Virginia Code)
April 30 and
VIRGINIA LICENSE NUMBER
REPORTING CARRIER
Mixed Beverages-No.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
1.
R.
P.
M.*
of
2.
R. P. M.
3.
Proportionate
system
allocable
to
for
quarter
Virginia
percentage
(As
for
of
reported
quarter
.
to
D.
.
.
.
0.
.
T.
.
or
I
C.
.
.
.
.
C.)
.
.
.
.
.
.
.
.
.
.
.
.
:
.
:
P. M. allocable to Virginia (Item 2 + Item 1):
R.
4. Alcoholic beverage purchases f o r s y s t e m f o r q u a r t e r
actual
number
of
“minatures”
purchased
unavailable)
.
.
(State
.
.
gallonage
.
.
.
.
%
if
.
.
.
:
allocable to Virginia (Item 4. X Item 3.) . . :
5. Alcoholic beverages purchases
6. Carrier’s estimate of average number of drinks consumed in Virginia during
quarter
(Assume
1.7
oz.
per
drink)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
:
7. Carrier’s estimate of tax due Commonwealth (Item 6. X $ . 10) (Do not make
r e m i t t a n c e
*R.
P.
M.
w i t h
t h i s
r e p o r t ) . . . .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
:
$
- Revenue passenger miles
*********************************
I declare under the penalities provided by law that
the
above
information
is
true
and
correct
according to the best of my knowledge and belief:
(FOR A. B. C. DEPT. USE ONLY)
Average
Tax
number
calculated
by
drinks
Board
.
(Remit within 5 days to
fixed
.
.
.
by
.
.
Board
:
(Person Preparing Return)
$
“Department of Alcoholic
Beverage Control”)
(Title)
Virginia Alcoholic Beverage Control Board
DATE:
,20
(TITLE)
DATE:
, 20
.
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